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High gradient


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  • High gradient

    I had my first visit at the Cleveland Clinic in April and just recently went back for an echo in 6 months. I kind of had a feeling that something was wrong when the echo technician asked me what kind of symptoms I'd been having and what medicine I was taking for it. Dr. Lever started me out on 40 mg of Cosgard, but I was unable to tolerate it. When I walked it caused symptoms and made me sob when before the meds I wasn't sob so he had me to take 20 mg. My pulse without meds is usuall between 55 and 65. My bloodpressure runs in the medium to low range.
    The first time that I had an echo at the clinic my gradient was 74 and this time it was 200. He didn't tell me what it was when stressed ,but he did say that it was way out of sight. I'm wondering if anyone else has had a gradient of 200.
    I'm 66 years old and have had only a few symptoms. I'm mostly tired and sleep a lot. In the past 6 months I have had only one time when I thought that I might pass out and it only lasted for a few seconds. I don't seem to be short of breath and can walk up a flight of stairs with out much of a problem.
    I showed Dr. Lever my brother's autopsy report which showed that he had sudden death caused by an arrhythmia. He said that he couldn't say for sure that he had hcm because my brother never had an echo, but he thought that it was more than likely that his death was caused by hcm.
    Dr. Lever suggested that I have a myectomy. I said that I thought that it was only when someone has symptoms that they have a myectomy, but he said that you don't want to go to sleep some day and not wake up. So I am scheduled for a myectomy on Jan. 27, 2005.
    septal myectomy on Jan. 27, 2005

  • #2
    Re: High gradient

    Bettie, It's good to hear from you again. I'm glad you went to Cleveland and I hope you are able to get all your questions answered and feel good about your course of treatment. Surgery is a big step, but when necessary, it's the way to go. I'm glad you are feeling pretty good. Starting out in good shape will certainly aid in your recovery. Best wishes and please keep us posted. I know you will receive much encouragement here, from those others who have seen the benefit of surgery. Linda


    • #3
      Re: High gradient


      It sounds like your doctor certainly is advising you correctly. You are symptomatic if you are very tired and sleep a lot. Yes some of this is due to the beta blocker slowing your heart down but , surely the stress of a high gradient causing your heart to work overtime to get the minimal job done is causing significant impact on your hearts overall health.

      My gradient at rest was variable as related to fluid management . For some time before diuretics it was 70 -100 at rest and in excess of 240mmHg pressure when active. The #'s fell a little with proper management of the CHF and fluid overload . However the numbers varied and rose as my heart began to show progression of the disease. I am 51 and had the myectomy at 50 . It is a big step and decision but as your doctor points out the risk of developing a fatal arrythmia when you lie down and go to sleep is of predominant concern. As evidenced in the force in which your heart has to work to get each surge of blood out and around to the rest of your body, the pressure gradient alone left me thinking , " What if I have an aneurism, as this is in my family history, I felt surely that I might one day explode all over the place someday soon. " Not a good thought or pretty picture.

      So , I am very glad you are having the myectomy . I know you mean 2005 not 2004. Soon you will have all this behind you and on your way to a healthier heart and better quality of life : less sleeping for one.

      Keep us posted and you are in my thoughts and prayers as you embark on this most necessary journey.

      Dx @ 47 with HOCM & HF:11/00
      Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
      Lead failure,replaced 12/06.
      SF lead recall:07,extracted leads and new device 2012
      [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
      Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
      Genetic mutation 4/09, mother(d), brother, son, gene+
      Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin


      • #4
        Re: High gradient


        That is a pretty high gradient i would also say lets go doc, and i agree the meds can make you tired but the stress your heart is under it needs some relief in there, i wish you all the luck and it isn't too bad i had one in Febuary of this year, just watch those sneezes and coughs

        Diagnosed 2003
        Myectomy 2-23-2004
        Husband: Ken
        Son: John diagnosed 2004
        Daughter: Janet (free of HCM)

        Grandchildren: Drew 15,Aaron 13,Karen 9,Connor 9


        • #5
          Re: High gradient

          Bettie, I'm glad you had a chance to see an expert. I'll be thinking about you as you prepare for the surgery.


          Husband has HCM.
          3 kids - ages 23, 21, & 19. All presently clear of HCM.


          • #6
            Re: High gradient

            Scary isn't it? I'm sure there's a lot coming at you all at once. Especially the thought of Open Heart Surgery! When my Cardio first discussed a Myectomy with me, I couldn't believe he meant me! I guarantee, after the Myectomy you will suddenly remember all the "symptoms" you had, but didn't attribute to you HCM!
            They don't do the surgery, unless you need it & you were told by the best that you need it.
            Feel free to ask us all your questions, from a Patient perspective regarding the surgery & recuperation. We'll be happy to share our experiences. Take some time to adjust to the fact that you're doing this.
            You are making the right decision.


            • #7
              Re: High gradient


              I had my Myectomy at The Cleveland Clinic about 12 weeks ago. You are in great hands.
              Dr Lever is worth waiting for & if you had an appointment with him, you understand "WAITING".

              I only have good things to say about Dr Lever & The Cleveland Clinic.

              Wishing you the best for a speedy & easy recovery.

              Stuart Schwartz
              Cleveland Myectomy Club
              August 31, 2004


              • #8
                Re: High gradient

                You are in good hands at Cleveland - Best wishes!
                Knowledge is power ... Stay informed!
                YOU can make a difference - all you have to do is try!

                Dx age 12 current age 46 and counting!
                lost: 5 family members to HCM (SCD, Stroke, CHF)
                Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                Therapy - ICD (implanted 97, 01, 04 and 11, medication
                Currently not obstructed
                Complications - unnecessary pacemaker and stroke (unrelated to each other)


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