I’ve got a dodgy mitral valve, seen by cardiologist, and prescribed Apixaban. So I think it means people who have an artificial valve which needs a different anticoagulant, but I’m not sure. What I do know is that it is very common for people to have slightly faulty valves as they age and it doesn’t seem to be a thing cardiologists worry about. I think you could start and worry about the valve issue afterwards but if you feel worried about it a call to the cardiologists receptionist would probably get an answer.
Well my problem is not slightly dodgy - it’s moderate to severe aortic valve regurgitation and is monitored by echo every six months; what worries me is the electrophysiologist doesn’t seem bothered to talk to my valve cardiologist let alone actually see me ! He has sent An email in response to my GP’s referral more or less saying give her an NAOC and nothing else ! 6 years ago when I had AF I was prescribed flecanaide ( as nothing else worked to revert me) and then when that failed I had electrocadioversion followed by a cryoablation that worked for 6 years They just can’t seem to be bothered now !
My husband has had aortic stenosis, mitral valve & tricuspid valve regurgitation and has a pacemaker and has been taking DOACs for the last 8 years with no problems. He is assessed every 6-12 months with echocardiogram. As Buff said, the advice on not using DOACS is aimed at those with artificial valve replacements.
I understand how hard it is not being able to access your specialist directly and unfortunately we who use NHS services are all in that category, however, both your EP and your GP should be competent to make the decision as to which anticoagulant is most suitable for you - should they read your notes.
My husband was managed by his EP who called in other specialities for consults, if required. I would find out who is the lead specialist and managing your file overall and go with them IMHO, otherwise you can find yourself caught between conflicting advice - just saying from previous experiences.
Ps sorry that wasn’t meant to sound as though I don’t appreciate your reply - at least I know one person who is taking an NOAC who has a valve problem . Thank you
That’s OK, I can understand your concern. My cardiologist said anyone over 70 is likely to have a leaky mitral valve but an aortic valve is different especially if you are needing regular checkups.
Do you know what your CHADS2 score is? If it's +2 (female & 65 yrs or over, for example) they will put you on an anticoagulant as a matter of course. I was given them from my first A & E appointment for AFib and a year later have still yet to actually see a cardiologist. It's like painting by numbers! I could do that very happily for the money they get paid
I don't know what cardiology was like prior to Covid but the fact is that the whole system is in meltdown now. It certainly doesn't seem unreasonable to ask your EP for a discussion about your concerns, and in these difficult times you have to make a bit of a fuss or it won't happen.
Valvular AF generally refers to AF caused by stretching of the left atrium resulting from back pressure into it by the mitral valve so nothing to do with the aortic valve. Take them please to protect yourself from stroke.
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