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Cardiologist and Cardiac Surgeon disagree on TAVR
My mother (87) has a leaky heart valve. Her cardiologist is pushing her to have TAVR surgery. The cardiac surgeon (same practice) isn’t pushing as hard and when asked, he said it likely would not improve her quality of life or longevity. Mom’s legs are starting to suddenly give out and she gets nausea and dizziness during a “spell.” She has high BP and some dizziness from meds but her dizziness has become worse. Over the last few months, she is limited in being able to walk even with her walker. She doesn’t have any other major health issues. She has become quite thin over the last several months.
What does one do when two specialists disagree? Get a third opinion? Thank you for any advice.
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I would consult another cardiologist. A surgeon has a lot of experience because patients come back to them for up to three, four visits over the next 12 months for a checkup and verification that the healing is going well....AND...that the desired result is bein realized, even if very slowly. But the cardiologist is a heart specialist who also brings a lot of experiential information, not to mention the specialized learning that the surgeon won't have in all likelihood...although many physicians have double and triple specialties these years.
Your dear mom's symptoms can have causes unrelated to her heart issues. Her sodium could be low. My father has, three times in the past seven years, been to the ER feeling terrible, only to find that his sodium is just below the lowest accepted empirical value for 'healthy humans'. She may have vasculitis or peripheral vascular disease, have collapsed cartilage in her spine causing some stenosis and poor enervation that affects her extremities. I'm guessing that enlargement, or hypertrophy, of the various chambers of her heart has been ruled out? No cardiac insufficiency, or 'heart failure'?
I'm just thinking mostly that there might be a need to consult with an internist, and endocrinologist, a neurologist, a nephrologist...someone whose investigation might lead to a more comprehensive assessment of your mom's overall health. Blood pressure is regulated by the kidneys, mostly, and if they're not doing their job, or they're being overwhelmed by the byproducts of something else that is going on, don't we need to know that?
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2 ReactionsThank you for your response. All other organs and her vascular system are fine after many tests over the last couple of years. She has seen a nephrologist and endocrinologist. Her heart is healthy. She is going to ask her primary for an MRI to rule out TIAs. She does have vertigo but her legs have never given out before and the dizziness is severe. Best, Melody
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