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I have an identical twin sister, who went to a

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Practicing since : 1966
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I have an identical twin sister, who went to a new internist for her yearly examination. Because her doctor retired. She is very healthy, eats a healful diet, consists of fish, skinless chicken, lots of veggies, fruit. meat one a month. no white flour, past, or breads, only whole grain, no sugar or sweets. her HDL is 82, LDL 99, triglyserides 45

exercises 30 per day, and walks. She goes to the doctor & of course she get the white coat syndrome. He checked her and he told her she ha a slight murmur, that blew her mind. Shhe had a ekg & he said its good, now he is sending her for an echocardiagram & doppler. She is in a state of panic & so am I, because she is my identical twin sister. I need something posit, before we give our selves heart attacks. I forgot to mention she was uder stress for 6 months.
Posted Mon, 25 Mar 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 36 minutes later
Hi friend,
Welcome to Health Care Magic


Murmurs can be 'innocent' - meaning there may not be any organic cause / say anaemia, increased flow and so on.
Even in identical twins, there need not be 100% chance of diseases being identical in both persons.

Your LDL (bad cholesterol) is below the normal range. Great indeed!
HDL (good cholesterol) level is excellent - only a blessed minority have this high range. It protects.
Your life style is very good - proper diet and regular exercise.
The chances of heat attack is really very far away. Normal EKG is reassuring.
The tests are probably meant to rule out anything - rather than ruling in.
Be positive. All has been well till now / will be well in future too.

Take care
Wishing speedy recovery
God bless
Good luck
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Follow-up: I have an identical twin sister, who went to a 2 hours later
I am positive, my sister had her echo & doppler yesterday, the technician took it, and he jut told her it looks good, but her doctor has to tell her. My twin's sister cholesterol is better than mine. My HDL 77, LFL 113, Triglycerides 55. I'm still nervous for her until her doctor tells her the results. How long does it take about?
Answered by Dr. Anantharamakrishnan 3 hours later

ECHO and Doppler - the technique is operator-dependent / the results are mostly automated - they are there at the time of doing itself.

The doctor will have to go through them to confirm. The only deciding factor is the time available to him to access it - once he has it, it is a question of a few minutes only.

You must take things easy.
You should not allow extraneous factors to affect you.
If you are the problem, you are the solution!
Worrying does not solve or influence the outcome. It is waste of time and energy!
Practice relaxation exercises, bio-feed back, yoga and so on.

If the preliminary report is OK, everything will be OK.
The only thing may be - he is waiting for it to come through the horse's mouth...

God bless you
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Follow-up: I have an identical twin sister, who went to a 6 days later
It's been one week since my twin sister took the echocardiagram & doppler. She cazlled the doctor's office today and the person that answered the phone said he didn't receive it yet, she said the cardiologist didn't read it to send the results to her doctor. The aticipation is making her even more nervous and also me.Does a doppler and echo usually take that long. I know you told me not to worry, but it is getting us both into a very nervious state, My sister has no symptoms of anything. She is very energetic, never gets tired or dizzy, That's why this is blowing her mind. Her previous doctor who had retired, and saw her every year, never told her she has a slight murmur. I need some positive answer, otherwise we are both going to go into the nut house.
Answered by Dr. Anantharamakrishnan 56 minutes later
Oh dear sister!

     That is no reason to worry at all.
     The situations are always similar – it is our reaction that differs. If there is no appointment, then where is the place for disappointment? Stop expecting / imagining...

     If the doctor has not reported so long, it is his problem! – Probably he has more serious things to attend to and your normal event is not a priority. Could it be that he is brushing up his memory after seeing such a normal one at this age? It is a question of minutes to retrieve from the machine’s storage / analyse / and report.
     The other day, I was listening to the radio; I heard a song, which goes thus! “Dear God! I need not and I will not worry about anything / Because I know you are taking care of me and I have left it to you / If anything, it is your problem to worry about me! / Leave it to HIM and relax.

     When there is no symptom, why should you worry?
     Even if there is a symptom, why should you worry? God has given it to a few people so that they can be investigated and treated.
     If there is a murmur, so what? Even new born children can have. Not everything turns out to be abnormal. Some murmurs are called “functional or innocent.”

     Either way, there is no cause for worry! May I mention here an old grandma’s funny story? – It was midnight and the lady had some noise in the kitchen. She prodded the man to go and have a look – possibly a burglar? The sleepy man told her that no burglar will be foolish enough to make noise; turned away and dozed off. A few minutes elapsed. The lady now said, “There is no noise now! Go and look!” The moral of the story is that the tendency to doubt and/or worry, is common and we should learn to ignore it / get over it.

God bless you
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Follow-up: I have an identical twin sister, who went to a 2 days later
It has been 10 days since she had her echo/doppler and she hasn't heard anything yet. When she called the doctors office on Wednesday, the girl told her it didn't come in yet. Does it normally take so long. I thought the doctor would have already got it on his computer. Between my sister and I we are building up such a negative illness. The reason why we are this way, is because we had never had any illnesses all our life. Our mom was the same way, which she had passed away at 95 years old from natural causes.e are both in good health, other than the glaucoma that we both have. When she gets her results, I will let you know.

Answered by Dr. Anantharamakrishnan 18 minutes later

Your personal history is very good
Your family history too is good indeed...
Blessed to have had mother in nineties..
You may even overtake it!

I am equally eager to know the results!

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Follow-up: I have an identical twin sister, who went to a 2 days later
I just want to let you know that my sister's doctor told der she has a mild mitro valve, I think he said regurgitation. He told her its nothing to worry about, it's very mild, and these come up when your a teenager, but our previous doctor never told her that. I'm going to go for a physical examination too, because it has been a year and a half since I went. I'm wondering if I have the same, because we are identical. We both have glaucoma, and we both had a skin cancer, squamous taken out, and had Mohs done, but thank God everything was clear. When we were in our teens, we were sun worshipers.
Follow-up: I have an identical twin sister, who went to a 2 hours later
I got it wrong, he said it is a mild mitral valve leakage, and not to worry. He doppler was excellent, no blockage.
Answered by Dr. Anantharamakrishnan 55 minutes later

Things turned out to be nothing of significance.

The only thing to worry about is worry itself.
Enjoy life

Have a good day - today, tomorrow, everyday!

God bless you
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Follow-up: I have an identical twin sister, who went to a 47 hours later
Hi Doctor Anantharamakirshnan, I'm writing you again, because my twin sister is becoming so stressful over the mild mitral valve leakage that was found in her echocardiogram, she can not accept this, neither can I. She keeps on going on google on the internet and she is getting all negative information. Her doctor told her not to worry, but of course she is still worrying. She is thinking of the worst, she said what if she needs a heart valve replacement. She feels excellent, thats why this is a shock for her. She doesn't get out of breath, does't feel fatigue. She is wondering if stress can have a lot to do with mitral valve leakage. She was under a lot of stress for one year. Dr. I feel very comfortable writing to you, because you have given me very possitive answers.
Answered by Dr. Anantharamakrishnan 1 hour later
Hello again

One does not treat laboratory values or Echocardiogram!
It is the patient, we treat – patient as a whole...

Just because something has been found doesn't mean that it should be treated.
Not giving any treatment is itself a treatment in such cases!
Actually it needs great expertise, experience, confidence and courage on the part of the physician to do this – many will not be able to do this. Ordinary doctors may simply write a prescription to satisfy the patient and skirt the situation! This only shows you are in good hands – your doctor is doing the right thing.

Many people have this finding – even the very young.
In her case too, it had been there in her for long / the doctor only discovered incidentally!
She didn't know till now and she didn't worry / there is no need now to worry, just because she has come to know. She has no problems from it / problems may take decades to occur; most likely may never happen at all

The web is flooded with information – it is all un-censored.
The problem is to sift the ‘sense’ from ‘mis-sense’ and ‘non-sense’ / and an array of technical jargon.
Have confidence in your consultant, not hearsay

You are taking such great care! She has been blessed with a twin – many aren’t...
Take her out – party, park, beach, cinema / encourage to read, see television.
She should have diversion / have hobby / new friends
Relaxation exercise / yoga / feed back can help
If she is still worried, she will benefit from Psychological counselling – unwarranted worry is anxiety neurosis. And the one focussed on heart is called Cardiac Neurosis... Psychiatric assessment and assistance is of great help in many.

Rest assured, she will be back to normal – in spite of doctors, if not because of doctors!!??...
I can see, you have the motivation – that is half the cure.
The rest is a question of time.

Good luck
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Follow-up: I have an identical twin sister, who went to a 2 hours later
I feel so much better when I read what you wrote. I'm wishing when I go to the doctor he finds the same with me, because we are extremely close. For the past year she was so worried about so many things, and she was worrying about me, because I to was under stress like her, and it got to the point that it started to affect my stomach, but it was all do to nerves. We really don't have anything to worry about, we both have wonderful children and grandchildren and husbands, I think it's because we both retired and have to much time on our hands. We are both in good health, good shape, and whenever we go to the doctor, we also get the white coat syndrome and our blood pressure goes up. Our previous doctor knew how we both were, but the new doctor doesn't.

Thank you, Doctor.
Answered by Dr. Anantharamakrishnan 1 hour later

Glad to know that I have been of some help.

Pleased to hear of the happy family.
It is rare indeed to see siblings, so much attached.
May God bless you....may be some ’evil eyes’ had sisturbed?!

There is an old proverb – “An idle mind is devil’s workshop”
Both of you (I didn’t get your names till now!) should keep yourself busy / not an employment, per se / but something like community work for disabled persons, elders’ homes and so on. When you help others, you help yourself too.

You need to develop courage. No need to be afraid of white coat – after all, we too belong to the same class! May be the ‘coat’ too may be apprehensive!? In some Children’s Hospitals, doctors skip their coats – literally – to ease the child’s apprehension.

There is one life / Enjoy it to the maximum / Don’t worry.

Best of luck
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Follow-up: I have an identical twin sister, who went to a 4 days later
This question is not for my twin sister, it is for my husband. I was able to get all his results on line from all his pre-op tests from the hospital he had the surgery and all his tests. My husband had back surgery in November, and everything went well. His cardiologist said he had an extra heartbeat, but not to worry. I was reading his echo results, and I am concerned about what I read: 1) there was a mild pulmonic regurgitation; 2) there is a 1+ (mild) aortic regurgitation; 3) abnormal tissue doppler of the mitral annulus is consistent with abnornormal left ventricular relaxation; 4) There is an atrial septal aneurysm; 5) There is a trace tricuspid reguragitation. This all sound so serious to me. He is 69 years old
Answered by Dr. Anantharamakrishnan 2 hours later
There is trivial/mild leakage of 3 of the 4 valves. It is commonly seen with increasing age due to degenerative changes / atherosclerosis. There is no cause for concern so long as the ventricular function is alright – he has no symptoms and his heart is well compensated.

Atrial septum is the partition between the two upper chambers of the heart. An aneurysm is bulging from thinning / weakness. Depending on the size, it can slow down the movement of blood a bit there and may occasionally be a source for clot formation – blood thinners are sometimes prescribed for this, in some cases. His cardiologist may prescribe, if there is a need.

The very fact that he withstood surgery uneventfully is itself an assurance.
Nothing need be done, except to follow up / repeat the ECHO after 6 months.
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Follow-up: I have an identical twin sister, who went to a 2 hours later
Thank you for answering, everytime I get your answers, I feel so much positive. Doctor, I rated you excellent, which you are. Thank you again. I wish more doctors are like you.

God Bless you.

Sincerely, Kaye Cerri
Answered by Dr. Anantharamakrishnan 26 minutes later
Thank you for the complement
There sure must be better doctors everywhere -
As the proverb goes - The best is the one not yet seen!

God bless you
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Follow-up: I have an identical twin sister, who went to a 11 hours later
Are there any way of preventing mild mitral valve leakage and other valve leakage from getting worse later on. Can it be under control with exercise and diet and of course getting an echo 6 months to a year from a doctor. I am really very concerned over this. I think maybe I'm going to XXXXXXX but I need to know.

Thankyou, in advance.
Answered by Dr. Anantharamakrishnan 19 minutes later
No need to do anything.

Take care of co-morbidities, if any... For example, if he has blood pressure, it is to be controlled well.
Keep the weight normal.
If he has to see a doctor for any reason, the doctor should be informed - he may give antibiotic before any procedure. Most people need antibiotic after many procedures - here, it is given beforehand to prevent possible infection of the valve and so on.

Otherwise, the thing to do is to forget it and carry on as usual
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