AI and Blood Pressure Variance

[peter piper]

33 female-no significant health history(migraines)-I was recently diagnosed with severe AI.I have had an EKG (normal)an ECHO(below)and a TEE.As of yet,the specific valve defect is a mystery.Symptoms include:dizziness,shortness of breath upon exertion,left arm pain and weakness,jaw weakness,vision disturbance(light regulation),chest pain(especially when laying,especially on the left side).I am currently taking 5mg Norvasc.I have a father with possible valve issues(endocarditis-died from other issues)and a paternal aunt that had recent valve surgery, almost death.I understand that my numbers look good so far.
Since the symptoms started (possibly before)I noticed that my blood pressure in my left arm was unusually low (mostly 70s/50s-varies-never over 80s/50s) my right arm is usually near normal-a bit lower with the Norvasc.During the TEE,no one got a manual reading of blood pressure on either arm, they could not hear a pulse.The only readings came from a machine.I am wondering the cause of the variance.Because my numbers look good, could the symptoms be related to the blood pressure and a secondary issue-not the AI.Any suggestions for discussion or exploration on next appt. are welcome.
LVenddiastolicdimension 3.9cm
       systolic         2.3cm
septal wall 1.1cm
Posterior wall 1.0cm
Aortic valve opening 1.8cm
Aortic root diameter 3.6cm
Left atrial daimeter 3.2cm
EF appeared 60%
Severe AI normal peak velocities @ 1.9meters/second
Trace mitral regurg./trace tricuspid regurg.
Also, should 4 children be evaluated? Thanks so much!

[peter piper]

Pickled peppers ;0)! (Wise with a sense of humor- hehe)

Thank you so much for your comments. I am learning all I can - patients are often their own best advocate - armed with the right knowledge that is.

I have decided to have at least one of my kids tested. I read an article yesterday about Adderall and kids with unknown structural defects. Because of the family history and the Adderral - I just can't see letting it go.

Has anyone else had any similar experiences with the blood pressure issue. I have heard a doctor mention Subclavian Steal syndrome. I have wondered if my symptoms were not related to a secondary issue.

Thanks for responding - and thanks to any and all in advance for any additional comments.

[woodruff]

Thank you, doctor, for that superb pdf.  Having been diagnosed fairly recently with mild AI, I am very grateful to you for the link.

[CCF-M.D.-MJM]

Hi pickeled peppers,

Sorry to hear about your symptoms and aortic valve issues.  The following website is a pdf file of the most recent valvular guidelines

http://www.americanheart.org/downloadable/heart/1150461625693ValvularHeartDisease2006.pdf

When aortic regurgitation is causing significant symptoms, the need for surgical correction becomes the issue.  Talk with your doctor about your symptoms and if they think your symptoms are from AI, it is time for probably time for surgical replacement or repair.  If they do not think it is time, consider a second opinion to make sure  -- you don't want to be wrong and miss your window for surgery.  People with normal heart function prior to surgery do very well with surgery!  If you need surgery, make sure your surgeon is an experienced in valve replacement.

If your children have a murmur, it is worth screening them.  I am not sure what to make of your aunt -- if she is older, her valvular problem is more likely aortic stenosis than regurgitation.  See if you can find out exactly what her valve lesion is and talk to your doctor about it or repost.

I hope this helps.  Thanks for posting.