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Forum Name: Valvular Heart Diseases

Question: Mitral regurgitation


 vivian2 - Tue Feb 08, 2005 7:10 pm

Hi, Doctor,

I have some question about my echo test results. My Echo test shows that I have "structually normal valves", however, it also shows that "there is minimal and clinically insignificant mitral regurgitation". Is this something I need to worry about? Do I need to do follow-up echo test periodically? If my valves are all normal, how come that I have the mitral regurgitation? Thanks for your time.
 dr_jumanji - Wed Feb 09, 2005 3:04 am

:D You need not worry.... that mild regurgitation wont harm you... sometimes the machines are too sensitive to catch display of colors across the mitral valve/... normal individuals may have it... 8)
 Dr. Yasser Mokhtar - Thu Feb 10, 2005 2:32 pm

User avatar Dear Vivian,

Totally agree with Dr. Jumanji.

The echo machines nowadays are so sensitive.

Why did you have an echo in the first place?

If you are not symptomatic and there are no other abnormalities on the echo, there is absolutely nothing to worry about and there is no need to do follow-up echocardiograms.

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

Yasser Mokhtar, M.D.
 vivian2 - Fri Feb 11, 2005 10:45 am

Thanks a lot for your reply, doctors.

I have been experiencing some forceful heart beats since July 2004. Although it is not very frequent, every time it occurs, it is scary. Sometimes, it is even painful ( I suspect it is PVC). That is why I saw a cardiologist and had an echo done. The results shows there is no other abnormalities than the minimal regurgitation. I was also on a 7-day heart monitor. Everytime I feel a sympton, I can push the button. The heart monitor also automatically detects arrhythmia. My cardiologist told me that there were no significant findings. But I somehow still don't feel reassured. Two days ago, I contacted the company that provide the heart monitoring equipment ( the company name is Cardionet) and asked about the detection of PVCs, they told me that the heart monitor only detects significant events, such as 3 or more PVCs in a row or several PVCs within a 30 minutes period. I also asked about the event window, they told me that when I push the button, they will go back 40 seconds to examine my EKG. My feeling is that I may have pushed the button more than 40 seconds after the sympton occured. That is why I am still worried, I am afraid that there have been arrhythmia that have not been detected. By the way, I am 28. Thanks again for your time.
 Dr. Yasser Mokhtar - Fri Feb 11, 2005 12:41 pm

User avatar Dear Vivian,

Arrhythmias can have lots of reasons, having extra beats, or early beats have several reasons including:

1. Thyroid gland disease.
2. Electrolyte disturbance.
3. Mitral valve prolapse.
4. Alcohol consumption.
5. Smoking.
6. Consuming too many caffeinated beverages.
7. Stress.
8. Fatigue and not getting enough sleep.
9. Other heart diseases such coronary disease, etc...

So, you have to have a blood test to check your thyroid gland and your electrolytes. An echo is done to rule out mitral valve prolapse. You have to stop smoking, drinking alcohol and caffeinated beverages and try to have enough rest and get enough sleep. These measures although they sound simple usually help a lot of patients get rid of the symptoms.

In the past, treating young healthy patients with no structural heart disease, who had pvcs with anti-arrhythmic medications was what physicians did. But now after a certain study was done and it was found out that lots of young healthy active people who don't complain of anything have pvcs (they knew that by making this cohort of people wear 24 hours cardiac monitors), and they were absolutely normal and they did not have any complaints and they went around doing their regular activities, a decision was made not to treat these people unless the feeling of the arrhythmia really bothers the patient.

In your case, you had a heart monitor and you are afraid that these might be pvcs. You don't have to worry about pvcs. It seems that you are bothered a lot by this feeling. You have two options (assuming that your thyroid is normal, you have normal electrolytes and you stopped doing all the things that you are not supposed to), first (and this might sound a little bit harsh), learn to live with those beats, second is to take medications to suppress these beats. Like you said, you are 28 years old, and it is going to be a little bit too long to take medications (that might have some side effects and cost you money) for an unknown period of time for something that is most probably not going to hurt you. It is your choice and you have to discuss this with your cardiologist to feel more comfortable about your decision whatever it is.

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

Yasser Mokhtar, M.D.
 vivian2 - Fri Feb 11, 2005 3:43 pm

Hi, Dr. Mokhtar

Thanks a lot for the information. I am so glad I found this forum. The doctors on this forum are so nice and patient.

I think the forceful heart beat may have something to do with stress. I have had blood test done, which has ruled out thyroid gland diseases. I don't smoke, drink or take caffeinated beverages.

As far as you know, is this sensation of forceful and painful heart beat common in people who has PVCs and an otherwise normal heart?

Thanks.
 Dr. Yasser Mokhtar - Fri Feb 11, 2005 4:45 pm

User avatar Dear Vivian,

Thank you very much for the update.

When one has an early heart beat (comes before its due time), the heart has more time to reach the next beat, what the heart does is receive blood and pump it out. Since the heart is not pumping, then it is receiving blood, and since there is more time available for the heart to receive blood, there is more blood that accumulated in the heart waiting for the next heart beat (to pump the blood out). Since there is an extra amount of blood in the heart, the heart has to pump harder to be able to pump all the extra blood that he received. That is why you feel this forceful heart beat. This is the normal sequence for a patient who has a premature beat.

There are patients who even notice that the beat that precedes the strong heart beat comes earlier than it should have and they express this by saying that they felt a pause before the strong heart beat.

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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