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Forum Name: Valvular Heart Diseases

Question: Severe regurgitation/pregnancy

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 Anonymous - Fri Dec 27, 2002 6:48 pm

I'm a 43 years old female. I have moderate to severe reguritation of the mitral valve.
My husband been annoying with requests of having another baby.
I told him I believe it would endanger my health. Not to mention that I take medications. Which I would not be able to take if pregnant.
Would you advise a woman not to get pregnant if he had that type of regurgitation?
 Dr. Yasser Mokhtar - Sun Feb 09, 2003 9:07 pm

User avatar Dear Nancy,

Thank you very much for using our website.

Answering your last question about dilatation of left atrium and when should a cardiolgist should be concerned. Your left atrium is not terribly enlarged. The reason that the left atrium is enlarged is that the blood goes back from the left ventricle to the left atrium (up the wrong way) and then the left atrium already has blood coming to it from the lungs so it has to get bigger to able to accomodate the extra amount of blood and then the same thing happens with the left ventricle, it enlarges to accomodate the extra amount of blood coming to it from the left atrium (although it will occur to you but this is originally the amount that the left ventricle gave back to the atrium), but let's leave it here.

Anyway, if the mitral regurge becomes severe and the patient becomes symptomatic then the left atrial dilatation will progress. The dangers that dilatation of the left atrium carries is development of an abnormal heart rhythm and stagnation of blood with development of blood clot in the left atrium that could brake down and cause blood clots anywhere in the body and the commonest is the development of stroke. The best way of course is to make sure that the mitral regurge is not progressing and if it then the best thing to do i guess is to go for valve repair if the valve is repairable and most of the cardiac surgeons now prefer repair because it prevents long term anticoagulation if you have a mechanical valve.

Now about pregnancy, mitral regurge is usually well tolerated during pregnancy unless very severe, because of some hemodynamic changes that occur during pregnancy. Regarding the medications there are medications that could be used during pregnancy safely without affecting the fetus. The problem is usuallu during labor because of the effort that labor pauses on the heart. But this can managed safely in the hands of an experinced doctor without problem and with good medical supervision.

You never said how your pregnancy went as it is usually the rule if the first pregnancy went fine and the mitral regurge has been more or less stable then the odds that your second pregnancy will pass without problems are usually very high.

Once more, thank you very much for using our website and i hope that i will not create any conflict between you and your husband regarding this matter as it seems i said what he wanted to hear. Good luck, and do not hesitate to post further concerns.

Yasser Mokhtar, M.D.

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