Aortic Insufficiency

[sandra kimmel]

After an echo, I was diagnosed with 3-4  aortic insufficiency.  My ejection fraction is 50% and every other aspect of my heart was within normal range, according to my doctor.  I was prescribed adalat and advised to get yearly echos.  The only symptoms I have are irregular heart beats which seem like skipped beats.



Will the adalat keep the insufficiency from progressing?  I am so terribly afraid of having surgery and the thought of this surgery is totally disrupting my life because I can't get it out of my mind.  I'm 49 years old and do not know how this valve problem developed.  I had an echo 13 years ago and nothing like this was detected.  I had a bad dental infection four years ago that resulted in pulling the tooth after an abscess and infection that lasted for about 5 months.  The dentist could not find the cause of the infection and after he pulled the tooth, saw that it was cracked and that was causing infection.  Could this have damaged the valve?  Other than that I had scarletina when I was 11, but not rheumatic fever.  I just don't know why this happened to me and am having a very hard time accepting this diagnosis.



How fast does this insufficiency progress?  Is there a chance that I would not need surgery for a few years if I stay on the Adalat?  



What is the mortality rate from this surgery.  I'm so afraid of complications such as infection or blood clots and of dying.  

Please tell me something to put my mind at ease.  It's so hard going from day to day with this fear.  It's affecting my marriage and my job.



Also, I have had to be on antibiotics about monthly for different procedures such as dental cleaning, cervical biopsy, colonscopy. Can this be harmful to the kidneys or can a tolerance be built up to antiobiotics.  If I were to have to have a hysterectomy, am I at high risk for complications from that surgery, due to my bad valve?  What precautions should be taken?  



I just worry about everything related to my valve problem and can't seem to see beyond it to my future.  



Please help me put things into perspective.  I'm just not enjoying my days because of this everwhelming fear of what my future holds.



Thank you so much.

[CCF CARDIO MD - DLB]

The medication should delay progression of the aortic valve leakage. I suspect that ultimately you will need surgery. No one can say for sure how long it will be before you need surgery. Likewise, no one can say with certainty what caused the valve to degenerate in the first place. It will be possible to do a hysterectomy, even with the valve leaking, but precautions will need to be taken during the surgery to make it as safe as possible. The antibiotics are unlikely to hurt your kidneys and you will not build up a tolerance from intermittent use. You will need to learn to live with this condition and the uncertainty that disease always brings. Fortunately, surgery is a well-established cure for your condition, when it is time.