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What Causes Fainting And Leg Pain When Diagnosed With Bicuspid Aortic Valve?
Question: Hello my name is XXXXXXX I'm a veteran and have to be seen at the VA. I have a bicuspid aortic valve with mild stenosis and calcification, an ascending aortic aneurysm at 4.3 cm. I had not been able to be seen due to red tape at the VA since 2013. I was seen on September 8th 2016 due to an aneurysm seen on my Mri. I've not been called to see anyone at cardiology until feb 2017. No one told me what they found and went and picked up the records myself to get this info. I'm symptomatic with fainting and dizzy spells, mild pad in my right leg though they both are painful. I have been randomly having all of my teeth hurt all at once with nausea and then it goes away in about two minutes but it's excruciating. I also have been having very painful arms and a lot of heavy heavy vascularity in my arms and they feel like they will explode with pressure. I'm not getting any news from the VA doctors. Should I go to the er if my arms feel like that again or my teeth? I'm so tired and winded at work and my job is very physical. I have no guidance and cannot even see a GOP until nov 4
Your insight would be appreciated
Your insight would be appreciated
Brief Answer:
My insight is as follows:
Detailed Answer:
Hello and thank you for your question. Welcome to HCM. I understand your concerns.
The main problem in your case is that you have bicuspid aortic valve, a congenital disorder which does not manifest its clinic until the 4th to 6th decade of life. This is a well-known congenital disorder of the aortic valve, which normally is tricuspid. The aortic stenosis generated by it, no matter the gravity, some time in life will eventually generate symptoms. This means less blood circulating in the peripheral organs, due to stenosis in the outflow of the heart. Those symptoms are mostly episodes of fainting (due to less blood to the brain, thus less oxygenation) and angina (due to less blood to the coronary arteries, which may be manifested with mid chest heaviness, pain in the jaw, left shoulder and arm). Also, the aortic root and ascending aorta dilation and/or aneurysm are a compensatory manifestation of the obstruction in the "lower floors", in this case the bicuspid aorta.
At the moment, every physical activity should be avoided and, yes, it is a good idea to be admitted to a hospital as soon as possible. The treatment for this condition is cardiac surgery with the replacement of the aortic valve and repairing the aneurysm and replacement of the ascending aorta with a tube (altogether called the Benthal procedure). Before this, some tests will be carried out in the in-hospital settings, such as trans thoracic and trans oesophageal echo cardiogram, to carefully assess the aorta and the valve, a computed tomography scan of the aorta, and a coronary angiogram, to also evaluate the coronary arteries so that, if there are in blockages whatsoever, during operation when the valve is replaced, also coronary by-pass is done (if needed).
Therefore, my recommendation is that in case of the biscuspid aorta that has produced clinical symptoms, the surgical treatment should be undertaken as soon as possible.
I hope I was helpful and thorough with my answer. I am happy to help, should you have any follow-up questions.
Best regards,
Dr. Meriton
My insight is as follows:
Detailed Answer:
Hello and thank you for your question. Welcome to HCM. I understand your concerns.
The main problem in your case is that you have bicuspid aortic valve, a congenital disorder which does not manifest its clinic until the 4th to 6th decade of life. This is a well-known congenital disorder of the aortic valve, which normally is tricuspid. The aortic stenosis generated by it, no matter the gravity, some time in life will eventually generate symptoms. This means less blood circulating in the peripheral organs, due to stenosis in the outflow of the heart. Those symptoms are mostly episodes of fainting (due to less blood to the brain, thus less oxygenation) and angina (due to less blood to the coronary arteries, which may be manifested with mid chest heaviness, pain in the jaw, left shoulder and arm). Also, the aortic root and ascending aorta dilation and/or aneurysm are a compensatory manifestation of the obstruction in the "lower floors", in this case the bicuspid aorta.
At the moment, every physical activity should be avoided and, yes, it is a good idea to be admitted to a hospital as soon as possible. The treatment for this condition is cardiac surgery with the replacement of the aortic valve and repairing the aneurysm and replacement of the ascending aorta with a tube (altogether called the Benthal procedure). Before this, some tests will be carried out in the in-hospital settings, such as trans thoracic and trans oesophageal echo cardiogram, to carefully assess the aorta and the valve, a computed tomography scan of the aorta, and a coronary angiogram, to also evaluate the coronary arteries so that, if there are in blockages whatsoever, during operation when the valve is replaced, also coronary by-pass is done (if needed).
Therefore, my recommendation is that in case of the biscuspid aorta that has produced clinical symptoms, the surgical treatment should be undertaken as soon as possible.
I hope I was helpful and thorough with my answer. I am happy to help, should you have any follow-up questions.
Best regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. REMY KOSHY
The va is not taking this seriously and are putting me off to February! I am not allowed Obama care and have a pre existing condition when trying to get private insurance.should I simply just go to the er? Should I try and see other cardiologist ? I'm pretty poor in the cash department so this is scaring me.
Are my teeth hurting for a reason? It's happening every day now
Are my lymph challenged arms a sign that I need to go to er?
With the 4.3 cm aneurysm, with bav is this concifered large as they think it's no big deal ? Everything I read says it is?
Are my teeth hurting for a reason? It's happening every day now
Are my lymph challenged arms a sign that I need to go to er?
With the 4.3 cm aneurysm, with bav is this concifered large as they think it's no big deal ? Everything I read says it is?
Brief Answer:
A cardiologist should assess you
Detailed Answer:
Hi again and welcome back.
Well, if you were my patient I would treat you exactly as I described in my original answer. Also, I noted that this surgery has to be done as soon as possible, and I did not mean these days. If the clinical symptoms are as frequent as you described, I recommend you to go to an emergency room and be assessed by a cardiologist. This can wait until February, as an original issue, but since the symptoms are frequent, the sooner you are consulted, the better.
I hope my follow-up is helpful. If you do not have further questions, close the discussion and rate the answer.
Kind regards,
Dr. Meriton
A cardiologist should assess you
Detailed Answer:
Hi again and welcome back.
Well, if you were my patient I would treat you exactly as I described in my original answer. Also, I noted that this surgery has to be done as soon as possible, and I did not mean these days. If the clinical symptoms are as frequent as you described, I recommend you to go to an emergency room and be assessed by a cardiologist. This can wait until February, as an original issue, but since the symptoms are frequent, the sooner you are consulted, the better.
I hope my follow-up is helpful. If you do not have further questions, close the discussion and rate the answer.
Kind regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Yogesh D
So you are saying that I should go to an er rather than wait until February for the VA to get around to seeing me? You stated that this can wait until February?
Where is the best cardio place if I could choose? XXXXXXX clinic?
Can you write a recommendation I can read to my BA doctor?
Where is the best cardio place if I could choose? XXXXXXX clinic?
Can you write a recommendation I can read to my BA doctor?
Brief Answer:
Hi again
Detailed Answer:
Welcome back.
All I was trying to say is that, this diagnosis may wait until February. However, as your symptoms have been increasing in frequency and severity, I suggested you to go, to an emergency room, so the attending cardiologist could take a closer look into your situation, and then decide whether this situation, with these symptoms, can or cannot wait until February.
I am not originally from the United States, therefore I cannot recommend you to which clinic is better. Sorry for the inconvenience.
I hope this is helpful.
Best Regards,
Dr. Meriton
Hi again
Detailed Answer:
Welcome back.
All I was trying to say is that, this diagnosis may wait until February. However, as your symptoms have been increasing in frequency and severity, I suggested you to go, to an emergency room, so the attending cardiologist could take a closer look into your situation, and then decide whether this situation, with these symptoms, can or cannot wait until February.
I am not originally from the United States, therefore I cannot recommend you to which clinic is better. Sorry for the inconvenience.
I hope this is helpful.
Best Regards,
Dr. Meriton
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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