lactate dehydrogenase post-TAVI

[Taviterry]

I joined this forum when I was concerned about fatigue that started eight weeks after I'd been given a new heart valve in July 2023. (I'd made an excellent recovery.) A private blood test in December showed slight dips in my main blood values compared with the previous January, making me slightly anaemic. NHS blood tests early this month showed nothing very remarkable, except a massive 490u/l for lactate dehydrogenase (normal range: 125-220).

An initial Googling of "LDH" suggested that this was not uncommon among those with replacement heart valves, and now I've come across websites - some highly technical - where the information concerns me.

In November my surgeon confirmed my heart was OK, as did the haematologist who saw me two weeks ago.

Any comments, please.

[DWizza]

Interesting about the private test showing up the anaemia. What did they do differently to the NHS test ? Have you asked ? Did you have any suggestion of anaemia , fatigue etc ?

Sorry , no experience with LDH.

[Taviterry in reply to DWizza]

I've been borderline anaemic for many years and the NHS and private readings were more or less the same, with the NHS conducting additional protein electrophoresis and serum free light chain tests. The private hospital took two phials of blood out of me, and afterwards I felt fine. The NHS took five that left me exhausted - two weeks later I'm still tired. I suspect that my body is taking its time to replenish red blood cells.

Naively perhaps, I've emailed the US manufacturer of the valve, Edwards, for any general recent information about the effect of TAVI on LHD and got a prompt reply requesting " valve serial number, model number, size of implant, implant date, implant hospital name/address and implant physician name".

With the US being so litigation-conscious I doubt that I'll get a meaningful further reply. I'm not "blaming" the implant, I just want to have some foreknowledge before my follow-up NHS consultation, hopefully in mid-April. I like to go prepared into such consultations, where I can struggle to keep up.

LHD relates to the lactic acid produced during strenuous physical activity and which often featured in fitness discussions by racing cyclists in the 1980s. My current symptoms certainly recall how I sometimes felt after long (over-long?) cycle rides forty years ago.

[Taviterry in reply to Taviterry]

I've just had a useful 17-minute phone chat with the Director Product Safety in the valve-maker's Quality International Department in the USA. We explored several possibilities, including a possible fault with the valve, but I was able to tell him of the reassuring results from an ECG my surgeon had arranged. He mentioned two areas for further investigation by my NHS haematologist that I'd wondered about myself and is going to send me links to relevant articles.

(As an ex-civil servant I keep a file of paper records which proved helpful when I was looking for different reports and results in response to the Director's questions.)