aortic sclerosis

[Detours211]

Hi
I have been having problems for a month now.  It looks as though I may have POTS (Postural Orthostatic Tachycardic Syndrome) although that has not been confirmed.

However, one of the things that is concerning me is that when we got the results of my echo, it showed mild aortic sclerosis.  I am only 29 years old.  Aortic Sclerosis is common in people who are 60+.

My first cardiologist (I have seen two) didn't seem to be worried about the mild aortic sclerosis.

My second cardiologist (an EP) said that in a 29 year old it is worrisome.  He thought it might be a good idea to have another echo, but my insurance may not pay anything for that and they are expensive tests.

Does anyone here have a history of aortic sclerosis (or mild) that you could post about here?  It may help me to calm down.

Please help.  Thank you.

[kenkeith]

QUOTE: "The left ventricle is not englarged but there is E:A reversal suggestive of reduced left ventricular compliance".

During diastole, the left ventricle should be able to accept a wide range of blood volumes without an elevation in filling pressure. The healthy ventricle also completes most of its filling during the initial phases of diastole; this property is particularly helpful at rapid heart rates when diastole is abbreviated.  E:A reversal suggestive of reduced left ventricular compliance meaning there is reduced filling of the left ventricle during diastole (filling phase) associated with some inability for the heart muscle to relax, etc..
Bottom line: Impaired left ventricular relaxation, poor left ventricular compliance, or both may lead to pulmonary congestion and clinical symptoms of heart failure; this problem is termed diastolic dysfunction. Worst case scenario.

QUOTE: "possible" PFO was spotted..."

That may not be a problem unless there is double shunting.  There is a hole between the right and left ventricle that usually closes after birth.  A small hole that does not close may/will cause shunting of blood from the left atrium to right atrium.  This blood is blood rec'd from the lungs and is oxygenated and mixed with the blood to go to the lungs to oxygenate...no problem.  However, if the hole is large and abnormal pressures from the right atrium exceed the left atrium pressure the blood will be shunted to the left ventricle and pumped into circulation.  Uncorrected the condition will cause hypoxia meaning there is a lack of oxygen in the heart muscle.  The result will be increasing the heart's workload and eventually causing heart failure if not treated.  

Worst case scenario, and in all probability there is no serious problem.  A bubble test would be decisive.  Take care and thanks for your response.

[Detours211]

Thank you so much for your response.  In answers to your questoins:

I used to smoke cigarettes on occasion from age 18 to 25.  This was usually with a cocktail at a bar.  I was never a full-time smoker.  

I was a relatively heavy drinker (lots of beer only, no other drinks) from the ages of 22 to 28.  i quit alcohol all together in December 2009 and haven't had a drink since.

I also am ashamed to say that I eat a horrible diet.  Lots of fried foods, potatoes, breads, cheeses.  And I drink a bunch of soda.  (I usually only do caffiene free soda for the last few months though).  My cardiologist today said that I should get off soda altogether.

I have a trileaflet aortic valve.  No aortic regurgitation.

The left ventricle is not englarged but there is E:A reversal suggestive of reduced left ventricular compliance.

Another point of note is that a "possible" PFO was spotted.  My cardiologist did not think anything of this but my EP Cardiologist said that I should begin taking low dose aspirin due to this possibility.  

I appreciate anything more you may have to share.

Thanks!!!!

[kenkeith]

For some insight sometimes calcium accumulates on the aortic valve, and the valve thickens. But the thickening does not interfere with blood flow through the valve. This disorder is called aortic sclerosis. You are correct about 1 out of 4 people over 65 have this disorder. However,  In young people, a bicuspid valve is the most common cause...has that been ruled out?.

If and when sclerosis becomes serious there will be a narrowing of the valve opening (orifice), and stenosis will increase left ventricle pressure causing concentric LV hypertrophy.  Mild aortic sclerosis will not cause any problem, but the underlying cause should be diagnosed and treated.  Smoking and drinking alcohol has been shown to cause the problem.  Recently, it has been disclosed that young casualities of the war who had undergone an autopsy showed coronary  artery disease.  So sclerosis may be happening with a younger group!?

Did your echo report show an enlargement of the left ventricle?