It turns out that my last echocardiogram had shown that my heart has remodelled itself back to how it should have been. With my new tissue valve in my heart, my heart has healed istself to become normal, perhaps for the first time in my life. Physical changes in my left ventricle which had occured due to my heart working much too hard to make up for my leaking mitral valve have reversed back to normal. My ejection fraction (measurement of heart efficiency) is now excellent. My blood pressure is well controlled. As a bonus my cardiologist told me I could come off my blood pressure meds as they would have been next to pointless given my good condition. He agreed that I was a success story. My careful lifestyle has really paid off for me. What had been a perilous time during and after two heart surgeries last year and several unpleasant later events, with careful medication and a healthy lifestyle I've healed myself.
As the cardiologist had agreed to take me off blood pressure meds I asked about the aspirin. I explained that there is now discussion amongst health professionals overseas suggesting that life-long aspirin medication may not have any measurable positive effects. What did he think about that? Yes, he agreed that was new thinking and in my case I could decide if I wanted to take a medicine that may have no positive effect on me at all. Taking aspirin doesn't give any bad effects other than bleeding prolongation if the patient has any surgery, accidents, bruising. I told the cardiologist that, given my age, it would be simpler to eliminate anything that could be detrimental in future interventions. He was comfortable with that. Woo hoo! No heart meds at all now.
I had chosen a tissue valve for my replacement heart mitral valve rather than a mechanical one as I did not want to be chained to Warfarin for the rest of my life because that would have neccessitated life-long blood testing, possibly diet control and risks of bleeding in accidents, or surgeries (occurances more likely as one gets older). I wanted to live my life as naturally as possible and I have now succeeded in that 100% where my heart is concerned. Plucky little heart - I felt immense gratitude and I also thanked the medical personnel who had helped and listened to me. In the back of my mind I also thanked myself for sticking to my guns against unnecessary medications and doctors who had not listened (which have caused issues in the past).
I'd like to explain what and how this awesome turn of condition happened through reverse cardiac remodelling.
Cardiac remodeling
can be described as a physiologic and pathologic condition that may
occur after myocardial infarction (MI), pressure overload (aortic
stenosis, hypertension), inflammatory heart muscle disease
(myocarditis), idiopathic dilated cardiomyopathy or volume overload
(valvular regurgitation ). I had the latter condition where my valve never closed properly and so much of the blood it pumped from the left atrium to the left ventrical flowed back to the atrium. It made me very tired with reduced exercise tolerance, palpitations and eventually important shortness of breath.
Cardiac remodeling is a process in which the heart adapts to changing conditions, with the ultimate goal of maintaining ideal pump function primarily by altering the tissue, thereby modifying the above parameters
Cardiac remodeling comprises changes in ventricular volume as well as the thickness and shape of the myocardial wall. With optimised treatment, such remodeling can be reversed, causing gradual improvement in cardiac function and consequently improved prognosis.
Predictors for this improvement were absence of
diabetes, history of hypertension, and treatment with beta-blockers; treatment with
beta-blockers increased the chance of reversal by 3.4 times
A number of medical therapies have been shown to promote reverse remodeling
with restoration of a more normal ventricular shape, reduction in Left Ventricular
volumes and mass, as well as an improvement in LV Ejection Fraction. ACE inhibitors prevent ventricular dilation and promote small
increases in ejection fraction, but reduction in ventricular diameter and increase in
ejection fraction are more significant with beta-blockers as they lighten the load on the healing heart.
The drugs used to
treat Heart Failure, particularly beta-blockers, ACE inhibitors, and ARBs, promote reverse
remodeling. Patients who present reverse remodeling during treatment have better
outcomes and lower mortality than those who do not present it. In my case, I was on a beta-blocker and an ARB. I got off them asap as they create other problems but initially they were important. It is worth noting that while I did have congestive heart failure until recently, I did NOT have clogged arteries and lung problems as a result of an unhealthy lifestyle. So what can we do to minimise heart problems and how can we speed up healing after cardiac surgery?
7 powerful ways you can strengthen your heart
- Get moving. Your heart is a muscle and, as with any muscle, exercise is what strengthens it. I walked a lot after my surgeries and I still work out in the hydrotherapy pool at Selwyn Aquatic Centre
- Quit smoking or vaping or better yet - don't start
- Lose weight. Most of the cardiac patients in the wards with me and in waiting rooms were all over-weight and most suffered diabetes as a result - so avoidable
- Eat heart-healthy foods. I grow a lot of my own so my body gets the best range of minerals and vitamins with limited contaminants
- Don't forget the dark chocolate but only in moderation
- Don't stress... easier said than done when negative events cascade
- Eliminate 'toxic' people from your life and only bother with those folks who love you for who you are.
Am I out of the woods now? I'd like to hope so, at least until my tissue valve needs to be replaced. I might have to have surgery in future to remove the stainless steel wires that were holding my chest together while my sternum grew itself back together as they have become irritable but that's minor compared to the long-term good news I have recently received.
Take care of your hearts dear Readers and they will take care of YOU!.
Photo credit : https://www.verywellhealth.com/what-is-cardiac-remodeling-1746198
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