aortic valve follow up scan diagnosis LVH

[andgrant1]

Following my aortic valve replacement, I have just had my first follow-up to check on the valve .Now have a letter from consultant advising results, that I have a normal sized left ventricle with mild concentric left ventricular hypertrophy and minor regional motion abnormalities related to my pacing and with a mild reduction of systolic function.. as it may be sometime until I have an appointment at clinic I wondered if anyone else had experienced this could help me understand the significance? I am actually assuming there was anything urgent they would have been straight away. This is not something that was noted on any of the scans prior replacement surgery. Thanks everyone.

[bikebabe]

Its frustrating to get information via a letter that doesn’t explain the significance and I’m sorry that I don’t have the experience or know enough to respond. If it meant further urgent action is required before the consult, one assumes it would have been detailed in the letter. Perhaps you could email the consultant secretary to ask the question.

[andgrant1 in reply to bikebabe]

Thank you, I agree it is frustrating when you get a letter first that you really don’t understand. I am hoping all is ok

[NotanAstronaut]

My take on all this is not too serious. I'm a retired GP but I don't have a license to practice now, so take this as a slightly better informed lay person!

The ventricle (lumen) has stayed the same size which is good. There is some hypertrophy (enlargement) of the ventricular muscle which is common when people have aortic stenosis, and to sometimes in aortic regurgitation too because the heart has to pump harder to get the blood out of the ventricle and around the body in the presence of a stenosed (narrowed) valve, or a valve that leaks some of the blood back into the ventricle. That said I believe aortic regurgitation tends to increase the ventricular size more to a bigger baggier ventricle. I'm sure this would have been spotted before surgery but may be not talked about much if it's mild. It's pretty normal by the time people need surgery for aortic stenosis.

Over time, now your valve is fixed I would expect the hypertrophy to go. It's a bit like former body builders who stop lifting weights. Their big muscles shrink down and in your/our case that's a good thing because thicker heart muscle needs more blood supply to it and more electrical conduction fibres which don't grow so fast and that can cause problems like arrhythmias.

It sounds like the minor regional motion abnormalities related to your pacing and with a mild reduction of systolic function are not serious, as they're described 'minor' and again may improve in time, particularly if, once you're up for it, you're able to get fit and active again. I'm no expert on any of this, just a person who happened to be a GP and who had a mechanical valve replaced nearly 18 months ago. My understanding of pacing is that the cardiologists try to place the pacing wire near where the natural electrical wave is initiated in the heart to create what is most similar to the electrical wave that stimulates a coordinated contraction of the ventricle muscle. Perhaps there is a small part of your ventricle that is not contracting despite the pacing - the so called motion abnormality, which will of course have an impact on your ventricular systolic function but it sounds to me that that is thought to be minor.

If you're doing ok I wouldn't worry. If you're not then I would go and have a chat with your doctor, if you can get into see them. I hope for your sake you're not in the UK where the NHS has pretty much collapsed.

[andgrant1 in reply to NotanAstronaut]

I really appreciate you taking the time to help increase my understanding from a medical standpoint. It’s helped a lot and reassured me that this may not be a significant concern. Thank you for doing this and yes, I am in the UK so am subject to the system here! Have a great Christmas and thanks so much again.

[NotanAstronaut]

You’re welcome. Have a good Christmas yourself too.

This might be interesting shaunoconnell.com/2023/08/1...

[andgrant1 in reply to NotanAstronaut]

Thank you,that’s such an interesting read and with me being born in 1966 has so many parallels to my own valve replacement earlier this year. I wrote a recovery blog also and wonder if you did likewise? So pleased to hear you are recovering well.

[NotanAstronaut]

I have drafted one but haven’t finished it. So share yours.

[andgrant1 in reply to NotanAstronaut]

here’s mine…online.fliphtml5.com/nsxmj/...

[NotanAstronaut]

Many thanks for writing this. A great reminder of much of it. You had a lot of surgery and got back to work fast! Best wishes for the future.

[andgrant1 in reply to NotanAstronaut]

Thanks so much, and best wishes to you also!