No Change In The Severity Of Aortic Stenosis!

The new Schuylkill Banks Walk extension.

It has been 12 months since my last echocardiogram. This year the result: stability!


2008 gradients: 22/36 mmhg
2009 gradients: 16/27 mmhg
2011 gradients: 25/40 mmhg
2012 gradients: 23/39 mmhg
2013 gradients: 34/53 mmhg
2014 gradients: 36/51 mmhg


2008 AVA: 1.3 cm2
2009 AVA: 1.2 cm2
2011 AVA: 1.1 cm2
2012 AVA: 1.3 cm2
2013 AVA: 0.8 cm2
2014 AVA: 0.91cm2


2008 ascending aorta: 4.25cm
2009 ascending aorta: 4.5 cm
2011 ascending aorta: 4.3 cm
2012 ascending aorta: 4.2 cm
2013 ascending aorta: 4.2 cm
2014 ascending aorta: no measurement


2008 aortic root: (SOV 3.5cm, STJ 2.55 cm)
2009 aortic root: 3.7 cm
2011 aortic root: 3.0 cm
2012 aortic root: 3.5 cm
2013 aortic root: 3.4 cm
2014 aortic root: not provided


2008 EF: 55%
2009 EF: 70%
2011 EF: 65%
2012 EF: 60%
2013 EF: n/a
2014 EF: 65-70%

New AHA/ACC Guidelines for 2014

Patients who have undergone valve replacement are not cured but still have serious heart disease. Patients have exchanged native valve disease for prosthetic valve disease and must be followed with the same care as those with native valve disease.

Either a bioprosthetic or mechanical valve is reasonable in patients between 60 y and 70 y of age.

Life Continues

Photo of Jim and Bradley taken by Bob Russell, July 2014.

Set to get my yearly echo in three months. The new AHA/ACC 2014 guidelines for the treatment of valvular disease are interesting. The timing of surgical intervention is totally dependent on the development of symptoms, either naturally or during exercise stress testing.

Bouts of Arrhythmia?

Lately I've been experiencing what I think are occasional bouts of arrhythmia that are becoming increasingly more debilitating...uncomfortable episodes while walking that included heart palpitations, chest pressure, shortness of breath with more rapid breathing, and fatigue. An episode about two weeks ago was much worse than the first one I had because I also broke out into a sweat and lost my color. Then I had another less severe episode. My cardiologist thinks that I'm feeling the arrhythmias more because of worsening aortic stenosis. So the plan is to identify the type of arrhythmia in order to determine the right therapy. I will use a CEM (cardiac event monitor) for a month.

Yearly Echo

Photo: Dan (L) and Jim (r) in 1983, the year we met.

Well, it has been 18 months since my last echocardiogram. There is some progression of the aortic stenosis. This doesn't surprise me, it just means that I will have to be more alert for the onset of any of the classic symptoms of severe stenosis, such as lightheartedness, shortness of breath, or fainting (of course!)

2008 gradients: 22/36 mmhg
2009 gradients: 16/27 mmhg
2011 gradients: 25/40 mmhg
2012 gradients: 23/39 mmhg
2013 gradients: 34/53 mmhg

2008 AVA: 1.3 cm2
2009 AVA: 1.2 cm2
2011 AVA: 1.1 cm2
2012 AVA: 1.3 cm2
2013 AVA: 0.8 cm2

2008 ascending aorta: 4.25 cm
2009 ascending aorta: 4.5 cm
2011 ascending aorta: 4.3 cm
2012 ascending aorta: 4.2 cm
2013 ascending aorta: 4.2 cm

2008 aortic root: (SOV 3.5cm, STJ 2.55 cm)
2009 aortic root: 3.7 cm
2011 aortic root: 3.0 cm
2012 aortic root: 3.5 cm
2013 aortic root: 3.4 cm

2008 EF: 55%
2009 EF: 70%
2011 EF: 65%
2012 EF: 60%
2013 EF: n/a

Time For An Update

Photo: Dan (left) and me on board the Celebrity Silhouette last month (August 2013)

So it's been 18 months since my last echocardiogram and visit with my cardiologist. The cardio switched universities from Penn to Temple so my appointment last May had to be cancelled. I will get an echo in mid-October and see the cardio then. The last time we met he told me to "put it out of you mind," because my condition was stable. I don't think there has been any significant change since then. At least I don't feel any worse. My only complaint is that I get winded going up steps or walking up a hill. The doctor said it was a combination of the aortic stenosis and my age. So if that's the worst I can't complain. We'll see how the echo and appointment goes in a few weeks.

DX: Stable

Good news again...the situation is stable.

2008 gradients: 22/36 mmhg
2009 gradients: 16/27 mmhg
2011 gradients: 25/40 mmhg
2012 gradients: 23/39 mmhg

2008 AVA: 1.3 cm2
2009 AVA: 1.2 cm2
2011 AVA: 1.1 cm2
2012 AVA: 1.3 cm2

2008 ascending aorta: 4.25 cm
2009 ascending aorta: 4.5 cm
2011 ascending aorta: 4.3 cm
2012 ascending aorta: 4.2 cm

2008 aortic root: (SOV 3.5cm, STJ 2.55 cm)
2009 aortic root: 3.7 cm
2011 aortic root: 3.0 cm
2012 aortic root: 3.5 cm

2008 EF: 55%
2009 EF: 70%
2011 EF: 65%
2012 EF: 60%