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Forum Name: Valvular Heart Diseases

Question: bradycardia and mitral regurgitation


 dadof6 - Sun Sep 16, 2007 8:03 pm

I am a 37 yr old male diagnosed with marked bradycarida. I am aware that my heart rate has always been brady even as a teenager byt because I was very active and participated in athletics noone ever considered it a problem. I haven't been serious about exercising in several years and yet my resting heart rate is about 44. I have no other symptoms but recently my dr ordered an echo which revealed mitral regurge, tricuspid regurge and pulm insufficency, however I haven't met with a cardilogist yet to see how bad the regurge is. How will my bradycardia affect treatment options and is there a relationship btw the brady and the regurge. Is it uncommon to see these 3 regurge types together. Also I read that people with mr should not participate in strenuous exercise because of the increased risk of CHF, is this true.
 dadof6 - Mon Sep 24, 2007 9:24 am

The results of my echo showed mild mitral regurge, a trace of tricuspid regurge and an enlarged right ventricle at 3.3cm. Is this a significant enlargement and if so what is normal size. Also I do not smoke and do not have shortness of breath, my ejection fraction is 64%. I am waiting for my insurance to kick in next month and will get a stress test. I am brady at resting btw 44 an 48. Do these conditions continue to worsen with age and what can it progress to.
 John Kenyon, CNA - Sat Jul 12, 2008 8:52 pm

User avatar Hello dadof6 -

All in all the findings you report seem to be near-normal, the only concern being the fact that almost every valve shows some regurgitation; however, in each one the regurg is minimal. The ejection fraction (EF), which is one of the most important indicators of healthy heart function, is very well within normal limits at 64; the right ventricle may be slightly dilated, but the measurement of 3.3 cm is confusing, as it is unclear if this is intended to suggest the degree of enlargement or the internal volume. In either case it would be rather small, so I am wondering if that number is either misplaced or misinterpreted.

It is not at all unusual to find some degree of regurg in the three valves as you seem to have, and all three are minimal. Mild mitral regurg is very common and is no contraindictation to exercise. Because of your history and your history of relatively sedentary lifestyle, any exercise program should be started slowly and progress according to exercise tolerance. The ideal way to do this is to follow the same protocol as the Cooper cardiac rehab program recommends. You can likely find this on line by doing a simple search, and it is only a suggestion.

Your bradycardia seems to be due to dominance of the vagus nerve in your autonomic nervous system. Some people are vagatonic (rate is normally slower) and some are sympathomimetic (normal rate is faster than "normal"). Since this has been a lifelong feature of yours and causes no symptoms, I would strongly recommend you ask your doctor for a specific exercise prescription to get you started toward cardiovascular fitness.

The insignificant degrees of abnormality you mention will not necessarily increase with age unless your cardiologist has since found some actual disease process. In all likelihood all your measurements are tolerable and within "normal abnormal" range.

Please do follow up with us, since by now you no doubt know a lot more about this. Hope this finds you in good health.

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