If you were wondering how this was diagnosed…it started back in 1995 while I was at Stanford.
I was enrolled in Air Force ROTC freshmen and sophomore year and sometime in the spring of 1995, I was sent to Travis AFB in Davis, CA for a physical. During his exam, the physician detected a heart murmur and instructed me to get an echocardiogram to check it out. I had the echo at Andrews Air Force Base in the summer of 1995 and all I really remember them telling me was that my murmur was benign and that they recommended I follow-up at some point (they were super unclear about this). I think they sent me home with some preliminary record of their finding and faxed the detailed results back to the examining physician. I recall sending my copy of the records from this sent to my primary physician to keep on file, but I never really thought about it again.
Over the last five years though, I’ve remembered it from time to time and thought I should look into it, but as you don’t often run into cardiologists on the street, it never seemed like an easy thing to do. That all changed last December when my mom had a bad reaction to some cold medication that affected her heart rate. She was kept in the hospital for observation…by a cardiologist! A light went off in my head and I asked her cardiologist if she could follow-up on my murmur and my old echocardiogram. And in preparation, I had my doctor fax me the original echo report which I actually read this time and it said that I had a bicuspid aortic valve. (Cue WebMD and rampant internet self-diagnosing.)
So in January, I had another echo to confirm the bicuspid valve and in the process discovered that my aorta was enlarged. [On a side note, the echo technician and I got along swimmingly and bonded over our mutual love of the Doppler effect.] Next, I had a CT scan to get a more accurate measurement of my aorta and the best cross-sectional estimate had the diameter just under 5 cm when it should be somewhere between 2-3 cm. Based on the textbook interpretation of this measurement, the cardiologist recommended that I meet with a cardiothoracic surgeon who would have a much better understanding of when surgical intervention might be necessary. As you can imagine, that wasn’t the most exciting thing to hear.
I consulted with my mom and my doctor (who is also a family friend) and decided to meet with another cardiologist in the Bay Area who sees a much higher volume of cases like mine, and who was in fact the cardiologist for my doctor’s wife who was born with the same heart defect (BAVD). After he examined my test results and scans, we had a long conversation about what exactly was wrong with my aorta and why. [On a side note, he saw right away that I was interested more than just my diagnosis, but also in the science behind it, and was able to explain things to me at the level I wanted to discuss them. Oh and we bonded as well, over our mutual love of our alma mater, Stanford.] In the end though, he agreed that establishing a relationship with a surgeon was the next step, so he consulted his cardiac colleagues at Stanford and sent me home with a recommendation.
His choice? Dr. Allan Stewart, Director of Aortic Surgery at Columbia-Presbyterian…which brings us to today.