Tuesday, July 27, 2010

Good update from cardiology

Wren had his 6 monthly cardiology clinic this afternoon. The clinic visit takes about one and half hours and includes echo, EKG, weight, growth and cardiologist consult. The background to the visit is that Wren's last visit showed a mild progression in the stenosis of his heart and the gradient across his aortic valve was 44. At a score of 50 we need to "talk about intervention". We have these 4-6 monthly clinic visits to decide when he will need the next cath or surgery.

The happy news is that he is stable.

This means he has:
  • mild mitral regurgitation,
  • mild-moderate mitral stenosis,
  • moderate sub-aortic stenosis,
  • aortic valve stenosis (the most worrying area now, contributing most to his gradient),
  • mild thickening of the left ventricle.
There was good news in one area, an actual improvement. This is the first time we have ever seen an improvement in pressures so I am very happy. The improvement is in the pressures in his lungs. These returned to normal this echo. The implication of raised pulmonary pressures is that his left atrium would be under higher pressure from worsening mitral stenosis.

EKG was normal

Blood pressures

Dr Lewin said that today's echo suggests that Wren's heart and blood flow are growing proportionally with him although he has been growing well.

He is now 16.1 kg (35.5lbs and 63rd percentile), and
40.47 inches (78th percentile)

I am happy that we are finally cleared to travel to South Africa!


Wendy said...

Glad that you got good news! It's a huge relief when you get to leave cardio appts without them scheduling a cath or discovering something new/worse pressures/gradients etc..isn't it?

Glad to hear you got the all clear for your trip! Awesome! Also happy to hear no caths or surgeries scheduled for you guys!


Laura said...

Thanks for the update. Glad to hear all is well and now you can start planning for your trip. Sounds wonderful!

nautilus said...

What a star Wren is; looks such a sweetie sitting there with all that monitoring going on.
AND how wonderful you are to survive / go through all this. I can hardly imagine your angst. Lots of love MUM

Shannon said...

Thank you all for the good thoughts. I am immensely relieved. Of course, afterwards, I thought "of course he looks great and I KNEW he'd be fine."

I have been wrong before, hence my neurosis.

Today, I bought a book on EKG at the thrift store :) It is very interesting.

Another titbit. At the last visit Dr Lewin said that we should "see signs" if Wren is doing badly. This time he said that since we have only about 6 points increase in gradient before intervention, we might not see a change in his well-being at that threshold.


Still, its a good day.

Amy said...

Wonderful news for a beautiful family. Now I know what it will look like when Josh is Wren's age and getting his check ups. I hope he is as well behaved. Wren is a gorgeous child, and I am keeping him, and your family in my prayers.

Laurie Clark Klavins said...

So so so happy to hear this!!! He looks like such a trooper in those photos, I know he's not a huge fan of the doctors. :-)

Now to fret about S.A. prep!! I am sad not to be there as you all depart....