Pictured – Margaret Deem, Patient
Dr. John Rawlins
Consultant Interventional Cardiologist, University Hospital Southampton NHS Trust
Margaret Deem’s lower leg pains and breathlessness weren’t signs of ageing — they were symptoms of a potentially fatal heart valve condition. A minimally invasive valve replacement procedure saved her life.
Margaret Deem’s health problems started with gripping pains in her lower legs, breathlessness and sometimes dizziness, but originally only when climbing the stairs.
Yes, she was in her eighties – naturally she felt some signs of ageing, but she still had an extremely active life, walking with her husband and dog. When her symptoms continued, her GP told her she had a heart problem.
Margaret didn’t realise that she was experiencing the symptoms of aortic stenosis (AS), a type of heart valve disease which if left untreated can be fatal. “I felt very ill,” she remembers. “After being told the facts, I worked frantically, as if there were no tomorrow, feeling I had to sort important issues whilst I still could. I felt that if I had been in danger, I would have had agonising heart pains.”
Margaret and her family knew something wasn’t right. “Mum hadn’t been herself for a couple of years.” said Fiona Woodfield, Margaret’s daughter. “It was subtle to start with — so subtle that no one took that much notice. But, over time, the symptoms became more severe.”
Treatment for aortic stenosis
Margaret had an electrocardiogram (ECG) and, within a few months, was diagnosed with AS. She was amazed, because she always thought that heart problems would appear as a searing pain in her chest.
Yet Dr. John Rawlins, Consultant Interventional Cardiologist at the University Hospital Southampton NHS Trust, notes that — while chest pain can occur with this condition — breathlessness and a persistent cough, dizziness, and aching legs are all AS symptoms. “Degenerative AS affects roughly 10% of patients over 80,” he explains. “As we age, the aortic valve can progressively degenerate, calcify and narrow, which reduces the flow of blood through the heart.”
Margaret was told she needed transcatheter aortic valve implantation (TAVI), where an artificial replacement valve is inserted into the heart, usually via the main artery in the groin. “The TAVI procedure is less invasive than cardiac surgery,” says Dr Rawlins. “There are still risks to TAVI, but it requires less recuperation time and hospital stay than traditional surgery.”
Our hospital hasn’t changed its activity levels throughout the pandemic and continues to offer the procedure on the basis of its impact of both quantity and quality-of-life post-procedure.
Seeking help from your GP
Margaret was scheduled to have her procedure in early 2020, but when the pandemic struck it was postponed. However, in early July, she deteriorated rapidly. “We went for a walk in the forest and mum felt so unwell she had to keep lying down,” remembers Fiona. “The next day, she went to bed and that was it.”
Feeling her mum could wait no longer, a worried Fiona left messages as well as emails with the specialist and cardiology department. When a member of the TAVI team heard the seriousness of her symptoms, they called back and Margaret was told to come to hospital immediately. She was taken into a separate, COVID-secure room which made her feel safe; she was admitted, monitored and underwent the TAVI procedure as an in-patient.
“I feel fine again,” says Margaret. “Nobody should be worried about having this procedure at this time. In both hospitals, extreme precautions were taken to avoid infection.”
Fiona says, “I’m so grateful that the amazing team has made it possible for mum to get through this operation and give her a new lease of life.”
Dr Rawlins’ message is simple: if you have symptoms of AS, see your GP immediately and ask them to listen to your heart with a stethoscope. “Our hospital hasn’t changed its activity levels throughout the pandemic and continues to offer the procedure on the basis of its impact of both quantity and quality-of-life post-procedure,” he says. “So COVID or no COVID — don’t delay. Seek a review to discuss your treatment options.”