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Heart Disease (Expert Forum)
questions about the relation of subclavian steal and aortic insuficiency
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questions about the relation of subclavian steal and aortic insuficiency
by Carole__0, Jul 18, 1998 12:00AM
in 1990 I had an echo done which showed a mild mitral mumur. In 1995 I had a complete subclavian steal and a dvt in the subclavian vein. Just prior to this they did another echo that showed both a mitral and aortic murmur both considered inocent. the subclavian steal was attributed to stenosis of the subclavian artery caused by radiation I had recieved in 1974 to treat hodgkins disease.
Recently I had an episode of acute fluid retention 14 lbs in 4 days and increasing SOB my PCP placed me on dyazide and ordered a repeat echo my Aortic valve now shows insuficiency and is stenotic, the ventricle is at the high limits of normal for hypertrophy, ejection fraction is still good.
My question is I am 41 years old is it possible the damage to the aortic valve was caused by the steal in 1995 which has since be opened with an angioplasty, and now that I am on zesteril and lasix is this stable or are the two totally unrelated and am I looking at continued progression and a valve replacement in the near future < 5 yrs?
Recently I had an episode of acute fluid retention 14 lbs in 4 days and increasing SOB my PCP placed me on dyazide and ordered a repeat echo my Aortic valve now shows insuficiency and is stenotic, the ventricle is at the high limits of normal for hypertrophy, ejection fraction is still good.
My question is I am 41 years old is it possible the damage to the aortic valve was caused by the steal in 1995 which has since be opened with an angioplasty, and now that I am on zesteril and lasix is this stable or are the two totally unrelated and am I looking at continued progression and a valve replacement in the near future < 5 yrs?
Doctor's Answer
by CCF Cardio MD - MTR, Jul 18, 1998 12:00AM
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Dear Carole, thank you for your question. I believe the subclavian steal and aortic valve disease are unrelated issues. It sounds like the subclavian steal was appropriately treated with angioplasty, but even if that were still present, I doubt that would contribute much to your aortic valve disease. Without knowing the results of your echo, it's hard for me to comment about the timing or valve replacement surgery in your case. However, the fluid retention you mention indicates that you had some heart failure which may signal that your aortic valve is degenerating. You will need valve replacement surgery at some point in the future though because the valve will only get worse with time; it's just difficult to predict how long that will take. Medications may delay surgery slightly but rarely have a significant impact on the timing of surgery. Since you have mixed aortic valve disease (insufficiency and stenosis), it will be harder to determine when you need your valve replaced. For aortic insufficiency, the valve is replaced when the ventricle begins to dilate or lose contractile function on an echo. For aortic stenosis, the valve is replaced when symptoms like chest pain, loss of consciousness, or heart failure develop. You should peruse the heart forum's frequently asked questions section and previous questions still listed to find out more information about aortic valve replacement and the options available. I hope you find this information useful.
Information provided in the heart forum is for general purposes only. Specific diagnoses and therapies can only be provided by your physician.
Dear Carole, thank you for your question. I believe the subclavian steal and aortic valve disease are unrelated issues. It sounds like the subclavian steal was appropriately treated with angioplasty, but even if that were still present, I doubt that would contribute much to your aortic valve disease. Without knowing the results of your echo, it's hard for me to comment about the timing or valve replacement surgery in your case. However, the fluid retention you mention indicates that you had some heart failure which may signal that your aortic valve is degenerating. You will need valve replacement surgery at some point in the future though because the valve will only get worse with time; it's just difficult to predict how long that will take. Medications may delay surgery slightly but rarely have a significant impact on the timing of surgery. Since you have mixed aortic valve disease (insufficiency and stenosis), it will be harder to determine when you need your valve replaced. For aortic insufficiency, the valve is replaced when the ventricle begins to dilate or lose contractile function on an echo. For aortic stenosis, the valve is replaced when symptoms like chest pain, loss of consciousness, or heart failure develop. You should peruse the heart forum's frequently asked questions section and previous questions still listed to find out more information about aortic valve replacement and the options available. I hope you find this information useful.
Information provided in the heart forum is for general purposes only. Specific diagnoses and therapies can only be provided by your physician.
