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Does Minimal Leakage From The Prosthetic Heart Valve Require Medical Attention?
Question: MY FEET 'TINGLE'
I had heart surgery in Oct. 2016. They replaced my AORTIC VALVE-MITRAL VALVE- & Repaired my TRICUSPID VALVE. They also implanted a PACEMAKER. I have my PACEMAKER checked every 4 months.
I am Set to pace below 40 bpm. I'm told it actually paces only .4 % of the time. I had a NUCLEAR STRESS TEST last OCT. 2017 and my heart was OK.
QUES. # 1 - I'm told that my VALVES leak 'a bit', and that this is NORMAL with Valve REPLACEMENT. Is this true? is this a problem?
QUES #2 - I notice that my FEET 'TINGLE' from time to time. My bloods show I am a close to diabetic but NOT THERE YET. I have gained weight, unfortunately. I weight 220 and am 5' 9".
My Podiatrist told me 'tingling feet' could result from my minor stenosis and arthritis in my back. BUT ALSO COULD BE ON SET OF DIABETES.
I am determined to lose at least 20 pounds in the next month- 2 months. When motivated, I can lose a lot of weight- 'LOW CARBOHYDRATE DIET'.
I will get my bloods in 2-3 weeks. DO I HAVE DIABETES??? IF I LOSE A LOT OF WEIGHT, CAN I REVERSE THIS PROCESS?
THANK YOU, XXXXXXX Freed
I had heart surgery in Oct. 2016. They replaced my AORTIC VALVE-MITRAL VALVE- & Repaired my TRICUSPID VALVE. They also implanted a PACEMAKER. I have my PACEMAKER checked every 4 months.
I am Set to pace below 40 bpm. I'm told it actually paces only .4 % of the time. I had a NUCLEAR STRESS TEST last OCT. 2017 and my heart was OK.
QUES. # 1 - I'm told that my VALVES leak 'a bit', and that this is NORMAL with Valve REPLACEMENT. Is this true? is this a problem?
QUES #2 - I notice that my FEET 'TINGLE' from time to time. My bloods show I am a close to diabetic but NOT THERE YET. I have gained weight, unfortunately. I weight 220 and am 5' 9".
My Podiatrist told me 'tingling feet' could result from my minor stenosis and arthritis in my back. BUT ALSO COULD BE ON SET OF DIABETES.
I am determined to lose at least 20 pounds in the next month- 2 months. When motivated, I can lose a lot of weight- 'LOW CARBOHYDRATE DIET'.
I will get my bloods in 2-3 weeks. DO I HAVE DIABETES??? IF I LOSE A LOT OF WEIGHT, CAN I REVERSE THIS PROCESS?
THANK YOU, XXXXXXX Freed
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello,
After having undergone with success such a broad cardiac surgery affecting several heart valves sites, followed by pacemaker implantation, it seems that a normal nuclear stress test is another good news.
Coming to this point, you have no evidence of cardiac ischemia and the fact that the pacing mode is active only 4% of the time is another positive finding (you are almost not dependent on pacemaker, so the potential adverse effects of a pacing including dyssynchrony are almost in-existent).
Now, returning to your questions, I would explain that prosthetic heart valves do have some minimal leakage and this is not called abnormal. It may be a central or eccentric leakage depending on valve class. You shouldn't worry about that!
All that is recommended is periodic echo followups in order to differentiate in a timely fashion this normally found clinically trivial valve leakage from any newly occurring pathological valve leakage.
Regarding feet tingling, I agree with your doctor that it could be related to diabetic neuropathy or lumbar canal stenosis.
Is the tingling triggered by resting or walking? If it is more prominent during resting, it could be related to diabetic neuropathy.
Otherwise, a lumbar canal stenosis should be investigated.
Coming to this point, I would recommend consulting with a neurologist and performing a lumbar spine X-ray study and a nerve conduction study to investigate for possible neuropathy.
Hope I have answered your query.
Take care
Regards,
Dr Ilir Sharka, Cardiologist
I would recommend as follows:
Detailed Answer:
Hello,
After having undergone with success such a broad cardiac surgery affecting several heart valves sites, followed by pacemaker implantation, it seems that a normal nuclear stress test is another good news.
Coming to this point, you have no evidence of cardiac ischemia and the fact that the pacing mode is active only 4% of the time is another positive finding (you are almost not dependent on pacemaker, so the potential adverse effects of a pacing including dyssynchrony are almost in-existent).
Now, returning to your questions, I would explain that prosthetic heart valves do have some minimal leakage and this is not called abnormal. It may be a central or eccentric leakage depending on valve class. You shouldn't worry about that!
All that is recommended is periodic echo followups in order to differentiate in a timely fashion this normally found clinically trivial valve leakage from any newly occurring pathological valve leakage.
Regarding feet tingling, I agree with your doctor that it could be related to diabetic neuropathy or lumbar canal stenosis.
Is the tingling triggered by resting or walking? If it is more prominent during resting, it could be related to diabetic neuropathy.
Otherwise, a lumbar canal stenosis should be investigated.
Coming to this point, I would recommend consulting with a neurologist and performing a lumbar spine X-ray study and a nerve conduction study to investigate for possible neuropathy.
Hope I have answered your query.
Take care
Regards,
Dr Ilir Sharka, Cardiologist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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