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Forum Name: Valvular Heart Diseases

Question: Mitral valve repair


 arabmare - Tue May 10, 2005 7:12 am

Hi,
I'm from the UK and have just found this interesting forum.
I was diagnosed with dilated cardiomyopathy/possible tachy related cardiomyopathy, anterior mitral leaflet prolapse with significant mr and refractory fasicular ventricular tachy. I had a echo 10 months ago with ej 33% , end diastolic diameter 6.2 with end systolic 5.2cm.
My cardio was going to do a mitral valve repair combined with a vt ablation but decided to try the ablation which i had done in jan this year.Up to now we think this has been a success, i've already had two failed ablations, and i was feeling a lot better than before. Had a echo 4 weeks ago and about a week after began getting symptons of sob with pressure on my chest like someone is sitting on me , dizziness, palpitations, swelling in my hands, night sweats, severe fatigue, no energy, no appetite, cough, nausea. Went to see my cardio yesterday for echo results which he said my heart had gone back to normal size, and pumping normally, ef 55% and moderate leaking valve. When i explained about symptoms ,he sent me for blood tests and ecg. Ecg was normal.He now wants to do 24 houe tape to rule out tachy, if no tachy he will consentrate on the leak and may do a tee echo. W ould a tee echo show anything differant to a normal echo.? Am I a candidate for valve repair considering the heart is almost back to normal?
I have lived with these symptoms on and off now for 7 years and I just want to feel normal again, i am only 38 and feel so old sometimes. Why am I feeling like this still if my heart is working normally?
Thank you for any advice you can give.

I am currently taking Nexium 80mg, effexor 150mg, bisoprolo 2.5mg and irbesartan 75mg.
 Dr. Yasser Mokhtar - Fri May 20, 2005 7:55 am

User avatar Dear Arabmare,

Your heart function has improved a lot, even to the lower normal range, there is no doubt about that.

Your symptoms are probably suggestive of still having tachycardia. i agree with your doctor to have the 24 hours heart monitor, if it does not show anything, my personal inclination is to go ahead and have an electrophysiologic study to see whether or not the tachycardia can be induced and may be have a new ablation if thought to be needed and feasable.

tee shows a lot more information about the heart because the view is much clearer than the regular echo. The most important in your case would be evaluation of the mitral valve leaflets to see whether or not they are repairable. Usually, the posterior leaflet is the one that is repairable in most cases, but will have to wait and see.

In your case, i don't think that you should rush for surgery, i think you can wait and see whether or not your condition is going to improve more as it has already started to and beautifully.

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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