Questioning increase in AVA

[gentamicinman]

I'm writing you today seeking advice.  I am dealing with severe shortness of breath in most of my activities.  My cardiologist is taking a wait and see attitude.

Here's a quick history in April 2006, my then cardiologist, put me on 32 mg of Atacand.

In April 2010 I experienced major shortness of breath and my Atacand was reduced to 16 mg per day.That relieved the shortness of breath.

My current GP doctor stopped Atacand in October 2012.

In November 2011 I had an echocardiogram at that time my LVEF was 60%.  The mean pressure gradient was 16.5mHG, the max pressure gradient was 30.0 mmHG.  The aortic valve area was calculated to be 0.70 cm²

That echocardiogram was performed in a hospital.  I had suffered it a stroke in November 2011 and the echocardiogram was taken while I was unconscious.  For all intents and purposes I am fully recovered from the stroke and other than my handwriting and some speech problems suffer no ill effects.

Because of my continuous complaints about shortness of breath my cardiologist ordered another echocardiogram in May 2013 At that time the LVEF was 66% the mean pressure gradient was 31 mmHG and the max pressure gradient was 54 mmHG.  The aortic valve area was calculated to be 0.98 cm²

I have to admit with worsening shortness of breath I am concerned and suspicious about the 40% increase in the calculated size of my aortic valve area.  

  My concern is now, that the aortic valve area is thought to be much larger than it was, my treatment has turned into a very conservative approach and I'm not sure that's the best solution for me, I would appreciate your feedback and comments.

[gentamicinman]

Thank you

I forgot to post I am a 76 y.o. Caucasian male
However I am confused who is responsible for reviewing the previous 2 echocardiograms?

[CCFHeart MD25]

The gradients you have are in the moderately severe range. Your aortic valve size changed based on the measurements attained at the time of your echocardiogram. If certain measurements change, then the calculation for the size of your aortic valve changes. Essentially, the gradients are real, I'm just not sure what the actual size of your aortic valve is. Given your symptoms, I agree that your aortic valve should be the main focus. It may require another echocardiogram, or reviewing the previous 2 to help determine what the actual size of the valve is.