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Forum Name: Valvular Heart Diseases

Question: Mitral Incompentence


 natalieg79 - Wed Feb 12, 2003 12:07 am

Hi,

I am a 24 year old female and have just been told that I have a mitral valve incompentece. A quick ECG was taken because I was having chest pain and came back abnormal, than a stress test ECG (after 15 minutes on the treadmill) also came back abnormal. Which lead to the ECHO. At such a young age, what could have triggered this?? I have heard that previous heart failures could lead to it, and I am scared that I was missed diagnosed 2 years ago for intercostal condilitis instead of a mild heart attack (2 ECGs show a old inferior infarc). What do I do?

Regards,
Natalieg79 :cry:
 Dr. Yasser Mokhtar - Wed Feb 12, 2003 9:42 pm

User avatar Dear Natalie,

Thank you very much for using our website.

A heart attack in a female at your age is extremely rare unless (as females are at your age are protected by their hormones against hardening of the arteries [atherosclerosis] which is the number one cause of heart attacks). Although that rare it is not unheard of. It happens in cases where the patient has many and severe risk factors for coronary atherosclerosis like high blood pressure, diabetes, high cholesterol, smoking, strong family history of coronary disease.

Coronary disease due to causes other than atherosclerosis are also very rare and for example include an embolus (blood clot coming from somewhere else not originating from the coronaries) to the coronary arteries.

An ecg with an old inferior infarct could just mean that you are short and stout or the simple fact that you were not taking an enough deep breath while the ecg was recorded.

15 minutes on the treadmill :shock: wow, touch wood, i have only seen few people who went that far. :?: :?: And what do you mean by abnormal stress test :?: :?: Going 15 minutes on the treadmill means that you reached stage 5 if you were exercised according to the standard protocol. Any body who reaches stage three and even has a real abnormal stress test then treatment would only be by medications and not by surgery. Also, going 15 mintues on the treadmill means that you have excellent physical fitness and aerobic capacity.

About the echo findings of mitral incompetence, how severe it is?? My guess it is not, as if you really had severe mitral incompetence you would have not be able to go that much time on the treadmill. My guess it was just an incidental finding. Since the echo was evented many otherwise healthy normal people were found to have trace or mild mitral incompetence. Unless you have mitral valve prolapse which could be the cause of mitral incopetence or have a history of rheumatic fever.

About heart failure in young patients, there is an entity called viral myocarditis which is a disease that be caused by nearly any virus and this virus causes damage to the heart and subsequent heart failure and the ecg can give the same picture as an old heart attack.

You did not mention anything about your heart function on the echo but my guess it is normal.

What do you do? i guess you have already been seen by your doctor who ordered all those tests. If he is not a cardiologist, then i would recommend that you see a cardiologist who can assess you and decides whether or not it is worth your while and money to be followed up by him.

Once more, thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Regards, :lol:

Yasser Mokhtar, M.D.
 natalieg79 - Thu Feb 13, 2003 1:52 am

Thank you for your reply.

The ECHO that I went for was yesterday, so the cardiologist that I am seeing has yet to receive the results. As a Human Kinetics student (4th year) and a personal trainer, I have the knowledge to be able to read the ECHO, ECG and EMGs. I do have a family history of heart problems, and that is one thing that does scare me. I have no other heath risks for CHD.

I took 2 ECG tests prior to going to the cardiologist that both should the 'old inferior infarc'. I believe that it was on the 3rd line of the ECG at the QRS section. I'm not sure right now as I don't have a copy. When I did the stress test ECG, the cardiologist said that I had great aerobic capacity, but there was some abnormal sections on the ECG. He said that it might be my heart that isn't sitting properly (perhads, slightly turned).

As far as myocarditis, that is what the doctor at the clinic and the cardiologist said that I may have had 3 weeks ago when I was complaning about chest pain. I'm just very confused because besides having a very low iron level (4 instead of 10-16), I'm healthy and lead a very active and healthy lifeslyle.

Do you have any other suggestions?

Regards
Natalieg79 :(
 Dr. Yasser Mokhtar - Thu Feb 13, 2003 10:01 pm

User avatar Dear Natalie,

You never told me about the questions i asked about your left ventricle function and the degree of mitral regurge.

My advice to you is to wait for your cardiologist and see what he will say.

i think that having a family history of heart disease should drive you to continue your healthy life style.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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