I knew even as a child that I had a heart murmur. No one seemed to think it was serious and no one ever recommended that it might be a good idea to keep an eye on my heart as I grew older. The other day I remembered going to a doctor maybe 15 years ago and complaining about the pounding in my chest. He didn't think there was anything wrong with me, and maybe there wasn't at the time. He just advised me to drink decaffeinated beverages. He didn't recommend any heart monitoring. Perhaps he should have.
When I found out in 2004 that I have AVD, I was still jogging. I remember I could jog for 20 or 25 minutes and then finish off with a sprint during the final minute. Even after I got the diagnosis I could still jog, and did so three times a week to prove to myself that I was all right in spite of the AVD. But by 2005 I found that I couldn't jog anymore. When I tried jogging I got an uncomfortable feeling in my upper chest - lower throat area, a tightness that felt like my head was going to blow off.
I saw a different cardio in January of 2006 for a second opinion, and I told him about this. We did a nuclear treadmill stress test then, but it was negative...at least the cardio made no diagnosis based upon the results of that test. My AS was still technically "mild" at that time, in all probability by the numbers, so he was probably looking for any evidence of CAD. However, I think the sensation I was experiencing at that time was related to my AVD. I may have been further along with the AS adjusted for my size even then, and he missed it.
So I now believe that this strange uncomfortable feeling, this tightness that I get is angina related to my AS. And I've been experiencing it since 2006. Angina, "chest pain," comes in many different flavors. It's not simply a sharp or dull pain. On of the best descriptions of angina I've ever read was posted by a fellow named Bob on the Heartvalvereplacement.com website with emphasis added by me:
Many people have angina and don't realize it. The classic is the left arm, left shoulder/back, or left-side-of-chest pain. However, it can also show up as a feeling at the top of your lungs like you've been breathing cold air, or a feeling like a lump in your throat, a tightness across the chest, or just a slight throat tightness. It can show up solely in your back, or be confused with heartburn issues. Or you can feel it as neck or jaw pain (this is especially common in women).It may well show up when (or just after) walking uphill or up stairs, although not necessarily every time you do it. It's often not the dramatic, agonizing pain that is portrayed on TV shows, but more of a lower level discomfort or an uncomfortable tightness. It can also show up at the end of the day, with you becoming aware of it when you first lie down (especially if you flop down after climbing stairs). You may also become aware of palpitations, which are misbeats or arrhythmias, in the evening when you are quiet. They tend to get worse as you approach surgery, and visit you in the darkness at night, when your spouse is asleep, and you are alone with the shadows on the ceiling. They tend to bring some sense of panic with them, which makes you more aware of them,and can generate a bad, endless-loop cycle when you most need sleep.
This is the most comprehensive description of angina that I have ever seen. Bob has it just exactly right. His comments on palpitations are spot on also. The bottom line is that I've had angina for a couple of years now, and palpitations for may years that have gotten worse particularly over the past year. During the past year, the palpitations have become so strong at night that I can't lie in bed on my left side or on my back for long. I have to sleep on my right side only.
When you put this all together, symptoms for two years or more now, severe AS, adjusted for body size...well, I didn't get to the surgeon a minute too soon, it appears. It will be interesting to see what he recommends on January 6.
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