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214864 tn?1229715239

High Left Ventricular End Diastolic Pressure (LVEDP)

I noticed yesterday that my LVEDP of 24 mmhg was listed as "mildly elevated" on my latest cath report. I looked up the normal values and found that this is elevated LVEDP (19-28 mmhg), and that >20 mmhg is considered diastolic heart failure.

I have been told that I have trivial mitral valve regurgitation, but hell, if this was caused by MVR  it doesn't seem trivial.

I pretty much know that it is not aortic or aortic valve stenosis, because there is no pressure gradient across my aorta.

I read where it could be due to long term ischemia, which causes damage or remodeling of the LV. My EF is 50 though.

The cath report also says I have course sounds coming from my right lung, which I read helps in the diagnosis of DHF.

I am trying to schedule evaluation for MID-CAB bypass surgery, and the actual surgery all in one trip, at the Cleveland Clinic today. They are doing me a favor :) I have been contacting many hospitals and cardio offices in Alabamy to forward my records to the bone collector...Thank G-D for a fax mochine.

My Lad is plum rotton. I have 4 stents in a "kiss me" arrangement (end to end). I am a perfect candidate for the minimally invasive bypass surgery. Just disconnect the mammary artery and hook it up downstream of the blockage. It could be on or off pump.

I was not impressed with the stenting and communication skills of the docs at the Cleveland Clinic. They left me with a 30-40% blockage in the middle of these stents, and didn't tell me, nor did they mention this DHF. I get the results from an echocardiogram I had here in Bammyland 3 weeks ago, tomorrow probably.

I shore would appreciate some information from anyone who has an idey about this LVEDP and DHF! Please suffer me this one time :)

Thanks so much in advance :)
23 Responses
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214864 tn?1229715239
Thank you so much for the very kind information, that I can always use. You never speak without saying something that is "for real", positive, and helpful. You have "got it together" for sure. I have known you to long to know that you would be fake about anything :)

I'll bet Canada is beautiful right now. I went to the Rockies and got some pretty good pics. The altitude like to have killed me. Now I know what a Colorado Rocky Mountain High is, lol. Will post some pics on my old web page soon.

Take much care,

Jack
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216258 tn?1189755827
and I hope *everything* will improve for you too !!
  
Vee
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216258 tn?1189755827
Jack , I meant to answer sooner to your kind post and your compliments. Thanks!  I am very glad you are not drinking anymore!! Proud of you! Water what I most drink, back and now too as you know.  Mentioning the good beer was more from nostalgia for younger years then real need. I miss coffee lately but only if smell it; but we can't have it all, can we? I liked what you said about our willpower. We have been giving a wonderful support to each other, and getting, the few of us who left. We value each other and each other way of dealing with LIFE.
I know I am well because I want to be well and enjoy every moment, EVERY! Good or bad and will fight no matter what life brings to my way, but never again with anger, but with smile on my face, and that coming from inside not a pretend one and I believe more then ever that it is what makes all the different. Or if not in a mood to smile, then a good realistic poker face will do!:)
No good byes! We are here to stay. Long!!  

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214864 tn?1229715239
I got my surgical evaluation date today, after lots of negotiating and arm wrestling :)  My appointment is 9/18/07 at the Cleveland Clinic. I hope that this will lead to minimally invasive bypass surgery. I really feel relieved. Now I got to keep the LAD clear enough to live, but blocked enough to have the surgery. This is the strangest situation I have ever found myself in. There is no such thing as preemptive bypass surgery. This situation is due to the bypass surgery capabilities of a very few hospitals in this country, and they may be thousands of miles from you.

Normally if you needed bypass surgery, you would get it. No problem except for the traumatic opening of the chest even for a single vessel bypass. I am just doing my best to avoid this. I know that y'all are tired of hearing me blog on this subject, but it is a life or death topic for me.

Hidy to all and I hope all of you are as healthy as can be,

Jack
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Avatar universal
I will look again.I did not get the mail, and I was looking for you yesterday.  I have an appt now and have to run, but will check later.
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214864 tn?1229715239
It took me forever to figure out who you were :) Nice to see you again. You look swell.

I do not understand part of your post, but thank you for the part that I do understand, lol. ( I am just a slow country boy).

You are welcome for the compliment and I meant it. Be well and happy :)

Jack
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214864 tn?1229715239
Thank you so much :) I am starting to feel like a mushroom (all mushy inside), LOL.
Take care of your lovely self :)

Jack
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214864 tn?1229715239
I have diastolic heart failure. My left atrium is enlarged and my left ventricular end diastolic pressure is 24 mmHg. >20 mmHg is considered diastolic heart failure. The high filling pressure in the left ventricle caused the left atrium to enlarge. I received my echo report saturday (in the mail) from 3 weeks ago, showing an enlarged left atrium. I emailed my last 2 echos to you yesterday S. Then I get this post from you :(

I have read that chronic ischemia to the heart muscle can cause this, among other things.

There is no doubt that my pulmonary pressure is high which will lead to pulmonary edema. I already have some. Time for 2 pillows.

So maybe you can understand why I was so depressed yesterday when I read your post S. I was feeling as low as I ever have, or maybe more than I ever have, when I posted to Vee. I feel low this morning. Think back to when you were told that you had heart failure. Now add to that the fact that you need bypass surgery sooner than later.

okd

Then your kind post appeared. I was totally off guard.
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Avatar universal
Yes, we are all sympathetic to your situation.  I don't know what to say, except be positive and proactive, but already are and already know that.  I hope your sugar is under control, and that you are fairly asymptomatic.  You never complain of severe angina.  Do you get it?  Do you have NTG at home?
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216614 tn?1195665072
Oh Jack....don't be broken hearted. You have to admit, it was quite an issue with some of the PVC peeps and is good to be vindicated.

It is also good to see you doing better emotionally.  

Hang in there

PS    thanks for the compliment to Seldom
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Avatar universal
LOL 2
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216258 tn?1189755827
No ! We are happy to see you being well too. We are happy to see you as we did back on those good old days ! I just know surfgirl feels the same as I do !  You better believe me OK? I will read your post tomorrow and will answer more, but tooo late now and my brain is tired.
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214864 tn?1229715239
That broke my heart. I guess that is all you wanted to hear from me on this board. So sorry S.
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Avatar universal
See, Cindy.  The "rumors" were fact.  Meet Jack.  LOL.
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214864 tn?1229715239
Ah now this is the Vee that I know :)

It is just great to once again talk to you. I am sorry for the past and especially some things that I said to you and all on the CHF board. I was drinking heavily which is no excuse, but I haven't drank in a long time and my head is much better.

You CHF guys always impressed me with your mighty willpower. I think that is why some of you are doing great, and I am so proud of you.....

You look most beautiful in your picture, and very healthy, or you had lots of makeup on....Ha ha ha :) Just kidding there.

If you go back to where the good beer and coffee is, just be glad that there is no iron curtain to fall on your head, as it did in the past......Ah you gonna shoot me now :) Gotta do some kidding with ya!

Myself, I have nothing but bad news (poor me). I will post a post that I made on another heart forum this afternoon, where I am as welcome as anyone there (I think, ha ha ha).

Take very good care of yourself and the Amazon girl :)

---------------------------------------------------------------------------------------

Thanks so much to both of you guys :) You keep hitting the nail on the head...

In the mail yesterday, I received all of my past cardiology records dating back to 1993. Whew, I had forgot how long I have been seeing these doctors. The Cleveland Clinic, back a couple of months ago, lost all of my personal medical records. This is why I ordered all of my records from my cardiology group.

In addition to all of the records, I received the actual results and the doctor's interpretation of an echocardiogram I had performed about 3 weeks ago. Shocked and amazed I wasn't, due to knowing my LVEDP pressure. My Left Atrium is enlarged. 5 of the 6 other echo measurements are very close to the abnormal range.

I have went through these records and am amazed at the abnormalities that were never reported to me, but of course they were sent to my PCP.

Overall, I think that I have had poor revascularization of blood flow to my heart muscle, due to my anatomy and less than a proactive approach (too conservative) to my treatment of CAD.

Time and time agian I see where a report has mentioned hypokinesis of my inferior and mid-anterior wall. I discovered another coronary anomoly that I had no idea of; a tiny subtotal high OM1. I need to look this up, but my cardio told my PCP that this is why I was having chest pain and nothing could be done because this artery could not be stented. Gee, I wish someone had of told me....

I also got the "raw" results of my 64 slice CT coronary artery scan that I had in September of 2006. Wow, for those of you that do not already know this, they check all of the major organs, lungs and chest for any abnormalities. I got a few lung nodules noted and "evidence of past granulomatous infection". I also have "scattered calcified hilar nodes and mediastinal nodes". No clue here...

Sorry for the OT stuff and sour attitude. Sometimes I don't understand why things work like they do, in the world of medicine.

Lately I have been busy writing to a cardiologist and surgeon at the Cleveland Clinic. I have been desperately listing reasons why my MID-CAB surgery should be expedited.

I have to go for an evaluation (cath) before I can find out if I am sick enough to have it. I have all kinds of reports stating how diseased (also still blocked 35%-40% and un-stentable) my LAD is, and how it can never be stented again. (4 stents already)

How long can you wait to have a massive heart attack, when you have extremely high cholesterol, cannot tolerate statins and are just plain chicken?

Thanks for the vent. I feel better already :)

XX and XX, thanks so much for the research and reply. Maybe I can return the favor.

Y'all keep smiling :)



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216258 tn?1189755827
I am doing great Jack. Thanks for hoping! I wish you to be healthy as it is possible and “strong" too.
I don't mind you "scold". Karma you know? ...but bluntness is my middle name. Remember? :)
What is in my head and heart, that what you got and get.

You right, our Seldom is a beautiful woman.:)

Mexico? Nahhh You know the good beer and good coffees are waiting for me the other side of the Ocean. Hope your day went well yesterday!

It was good to 'see' you happy again. I am glad about it !

Take good care of yourself !

Vee
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214864 tn?1229715239
You made my day!!!!!!!!!!!!!!!!!!!!!!!!
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Avatar universal
My dear Alabama Slamma............I have a rather dark pic on here.  I can e mail you others.  I am titty2shoes at the yahoo site.
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214864 tn?1229715239
Lost my dang post! Will try again...

Hello Sweetness!

Thanks so much for the information. I hope that you are doing great also, AND I hope that you were kidding about something you said (about family) to me here a couple of weeks ago :(

I know that you are in great physical shape....How bout a pic? Speaking of pics, boy that Seldom is hot-eh? Did you guys ever make it to Mexico? I hope Vee got to go also...

Hey I know nothing bout this left ventricular end diastolic pressure... I went to the CHF site and it listed the possible causes of elevated LVEDP, and one was HCM.

Thanks so very much for replying and big hugs to ya :)

Whackerhead

P.S. My first post that I lost made sense...
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214864 tn?1229715239
Vee, thanks so much for the well wishes. I really hope that you are doing just great. I wish that I could be "strong" like you speak of, but when you are waiting on the big one, it is tough to be strong. I am anxious and am having some angina. I am many miles away from the people that can fix me the easy way, and give me another life. (Is that drama or what, lol) There, I scolded you :)

I got nada sleep last night, so I am a tad more nuts than usual :)

(poor little me)
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Avatar universal
ask the doc on the other forum......inquiring minds.
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Avatar universal
I thought that an elevated LVEDP could also mean systolic heart failure, depending on your peripheral vascular resistance..........I am rusty, though.  I am confused too. I vaguely remember being chewed out by a doctor about this once, when I increased an IV med to help a post CABG patient's  BP, and the other intracardiac pressure  numbers increased due to peripheral vascular resistance............lasix would have helped his BP and LVEDP more..........I think.   Don't forget ACEs and BBs too, to unload the heart.  Good luck to you, Jack.
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216258 tn?1189755827
Good luck with the surgery !
  
V,
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