Cardiology Appointment

Today was a hard day. 

We left for Houston early, Hudson had rheumatology and cardiology appointments.  The rheumatology visit was really just a follow up from when he was in the hospital for the stroke/seizure incident.  The doctor wanted to make sure there aren't any hip or joint issues going on, and he was satisfied that Hudson looked great from that standpoint.  Easy visit!

Next up was cardiology, and that didn't go so well.  First they wanted to get an echo, which Hudson has never been able to have successfully done without sedation, but we all decided to give it a shot anyway.  I could not have been more proud of him!  He was perfectly still, watched the tv, and only kicked the tech once or twice :), even when they had to repeat parts of the echo 3 times.  I don't know if he cooperated because he's getting older, or if he is used to having people poke him now, whatever it was I was so grateful that he didn't scream the whole time!

The echo had some pretty shocking results for us.  Hudson has a hole in his heart, called an atrial septal defect, which at last measurement 6 months ago was 13 mm.  Today it was 20 mm.  Big increase.  Because of this hole, the right side of his heart is very enlarged.  His cardiologist wants the hole closed right away.  There are 2 ways to do this, one is with a catheter procedure, and the other way is via open heart surgery.  We obviously all would prefer the catheter procedure, but there are 2 potential obstacles in our way.  One is that Hudson doesn't weigh enough for the catheter lab doctor (who is a different doctor than our cardiologist) to want to do the procedure on him, he prefers patients to be at least 35 pounds, and Hudson is only 30-31 pounds, and has been at that weight for at least a year!  The other issue is that for the catheter procedure to work, there must be adequate rims of tissue around the hole, so that the closure device can "grab" onto the rims and stay in place.  The echo shows us that the rims around Hudson's ASD look too small.  There is always a chance there's more rim than the echo is showing, but his cardiologist feels that this could be a problem.

So, his cardiologist is going to sit down and have a big talk with the catheter lab doctor this week.  She is going to call us with their decision.  We can only pray that he'll agree to take Hudson as a patient in the cath lab.

The other issue that the echo showed us was a total surprise.  Hudson has another heart condition called mitral valve prolapse (he has 4 complications related to his heart altogether).  With MVP, the valve between the left atrium and the left ventricle of your heart doesn't close properly, and can result in blood flow leaking backwards into the atrium, which is called regurgitation.  Hudson's echos have always shown trivial regurgitation, meaning it's not a problem, this was evident as late as his last echo.  Today's echo showed a huge increase in regurgitation, meaning his MVP is now a big problem.  It is causing the left side of his heart to now be enlarged, fluid buildup, and his heart is showing a lot of strain.  The cardiologist said this all leads to heart failure, and has started him on an ACE inhibitor called Enalapril to ease the stress on his heart.  She thinks that ultimately he will need his mitral valve repaired or totally replaced. 

We don't understand how things changed so dramatically within the course of 6 months, but it could explain a lot of the strange symptoms we've been seeing in him lately.  His cardiologist is really a wonderful doctor who knows how mito can affect the heart very well, and I feel confident that Hudson is in very capable hands.  Please keep our sweet Hudson in your prayers.