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Yeah, I was always rubbish at biology but that's practically what was discussed today with the doctor at the Liverpool Heart and Chest Hospital. So it was a bit strange when I showed up as there definitely seemed to be a bit of a rushed, or last minute thing with me turning up today. Some people knew straight away why I was there, others seemed very confused and had to ask quite a few questions. My parents theory? That they know they've seriously screwed up and rather than there being a cancellation, they were trying to rush me in to make up for the mistake.
So after having an echocardiagram for what felt like the 100th time, I saw the doctor and gave him a full history of everything that happened and my previous history of having the holes in my heart checked. He then discussed the idea of what was going on. Sorry for those who know this already but I thought it might be good to explain it to those who don't understand it all.
The heart is made up of essentially two parts. The atria which are essentially the filling chambers, and the ventricles which pump the blood. These are then split up into a right side and the left side. Blood circles around the body, depositing oxygen and nutrients and returns to the heart with all the rubbish and things the body doesn't need. This fills up the right atrium, and is pushed out by the right ventricle to the lungs. The lungs act as a big filtering system, cleaning out all the crap including micro blood clots. Once cleaned and full up with oxygen, the blood returns to the heart and fills up the left atrium and is pushed to the rest of the body through the left ventricle.
The end...
Well not in my case. From birth I had two holes in my heart. One in the septum of the atrium and the other in the septum of the ventricle. The septums (what is the plural of septum? septi?) are what separate the left and right side of the hearts. These are called ventricular septal defect (VSD) and atrial septal defects (ASD).
Now back to why I had a TIA. A Transient Ischaemic Attack (TIA) is the result of a small blood clot entering the brain and stopping blood flow for a few moments before passing on causing no lasting problems. The question then, is how does a blood clot get to my brain. They had done tests and found there was no issue with my blood clotting abnormally, or issues with the arteries in my neck. The doctor at the Royal learned about the two holes in my heart and figured that this could have been the cause.
The issue is not with the VSD, since the pressure in the left ventricle is much higher than that in the right ventricle. So what happens there is that clean blood actually passes through into right side of the heart where all the "muck" is. The problem is actually in the atrium. The pressure in the left side of the atrium is only very slightly higher than it is in the right. So what can happen is that by any sort of straining, such as lifting things, coughing, walking, going to the bathroom, can cause the pressure in the right side of the atrium to be temporarily higher than the left. Which means the "dirty" blood can pass into the "clean" left side, which is then pumped to the rest of the body, including the brain.
So the situation we have is that the doctor at the CTC does not have all of my notes from when I was at Alder Hey Children's Hospital, and he has some notes missing from the Royal Liverpool Hospital too. So he wants to gather all of those. At the moment he can clear see the VSD but not the ASD. However I do remember clearly from my trip to Alder Hey about 10 years ago now, of being told I had both ASD and VSD. I got the impression that when the doctor found conclusive evidence of the ASD, he's going to perform surgery.
The way they are going to do this is through use of the Amplatzer Septal Occluder, which is surgery done using a catheter which avoids open heart surgery. This is a minor procedure and definitely not major surgery. I think this is going to be the route they will go though, unless the doctor is completely positive that the ASD is no longer there.
So that's where we're up to. Just waiting for the doctor to get the rest of my case notes and we'll be moving on from there.
So after having an echocardiagram for what felt like the 100th time, I saw the doctor and gave him a full history of everything that happened and my previous history of having the holes in my heart checked. He then discussed the idea of what was going on. Sorry for those who know this already but I thought it might be good to explain it to those who don't understand it all.
The heart is made up of essentially two parts. The atria which are essentially the filling chambers, and the ventricles which pump the blood. These are then split up into a right side and the left side. Blood circles around the body, depositing oxygen and nutrients and returns to the heart with all the rubbish and things the body doesn't need. This fills up the right atrium, and is pushed out by the right ventricle to the lungs. The lungs act as a big filtering system, cleaning out all the crap including micro blood clots. Once cleaned and full up with oxygen, the blood returns to the heart and fills up the left atrium and is pushed to the rest of the body through the left ventricle.
The end...
Well not in my case. From birth I had two holes in my heart. One in the septum of the atrium and the other in the septum of the ventricle. The septums (what is the plural of septum? septi?) are what separate the left and right side of the hearts. These are called ventricular septal defect (VSD) and atrial septal defects (ASD).
Now back to why I had a TIA. A Transient Ischaemic Attack (TIA) is the result of a small blood clot entering the brain and stopping blood flow for a few moments before passing on causing no lasting problems. The question then, is how does a blood clot get to my brain. They had done tests and found there was no issue with my blood clotting abnormally, or issues with the arteries in my neck. The doctor at the Royal learned about the two holes in my heart and figured that this could have been the cause.
The issue is not with the VSD, since the pressure in the left ventricle is much higher than that in the right ventricle. So what happens there is that clean blood actually passes through into right side of the heart where all the "muck" is. The problem is actually in the atrium. The pressure in the left side of the atrium is only very slightly higher than it is in the right. So what can happen is that by any sort of straining, such as lifting things, coughing, walking, going to the bathroom, can cause the pressure in the right side of the atrium to be temporarily higher than the left. Which means the "dirty" blood can pass into the "clean" left side, which is then pumped to the rest of the body, including the brain.
So the situation we have is that the doctor at the CTC does not have all of my notes from when I was at Alder Hey Children's Hospital, and he has some notes missing from the Royal Liverpool Hospital too. So he wants to gather all of those. At the moment he can clear see the VSD but not the ASD. However I do remember clearly from my trip to Alder Hey about 10 years ago now, of being told I had both ASD and VSD. I got the impression that when the doctor found conclusive evidence of the ASD, he's going to perform surgery.
The way they are going to do this is through use of the Amplatzer Septal Occluder, which is surgery done using a catheter which avoids open heart surgery. This is a minor procedure and definitely not major surgery. I think this is going to be the route they will go though, unless the doctor is completely positive that the ASD is no longer there.
So that's where we're up to. Just waiting for the doctor to get the rest of my case notes and we'll be moving on from there.
