Dear Mr. XXXXXXX

Thanks for your query to us.

"A little pain in chest" requires more description. That is if the pain comes with exertion//running/using stairs, if it is in mid chest, if it lasts for more than 2-3 minutes , if it is associated with sweating / shortness of breath? (Please provide these details)

A pain which does not come up on exertion/ exercise/ using stairs/ carrying weight/ lasts for less than a minute/ can be localized with finger/can be elicited with touch or comes up with deep breath, is less likely to be anginal pain.

Although your description suggests that your cardiologist diagnosed "Mitral valve prolapse" {MVP} and gave you medicine for same (ciplar) but it would be nice if you can upload your report, so that it is confirmed. Yes , in a large number of patients, pain associated with MVP get relieved by ciplar.
Yes, mitral valve prolapse is presence since birth mostly. Hence if we pick-up MVP on ECHO, it is presumed that it is there since birth. Mitral valve prolapse is a condition where one of valves of heart (mitral valve) is excessively flexible and prolapses into superior direction (into LA) from its normal closed position.

It may be associated with leakage of valve. The degree of leakage would have been there in your report.

Atorva was given for cholesterol lowering.

Please upload your report, provide more details and we will discuss.

Sincerely
Sukhvinder Singh

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Hello Mr XXXXXXX
Thanks for uploading reports.
1. Your ECHO shows mild prolapse of mitral and tricuspid valves (as I suspected) but they are associated with only trivial (insignificant) regurgitation. Yes, they are likely to be present since birth. At present, they do not seem to be significant and do not cause any problem. They also do not require any treatment. You need to repeat your ECHO after 5 years or if you have any symptoms like shortness of breath or easy fatigability.
2. Your ECG does not show any significant abnormality.
3. Regarding your lipid profile, please tell me
A. If you have diabetes/ high blood pressure?
B. Do you smoke?
C. If a blood relation has heart attack /angina, if yes at what age it started?
D. If you have any other medical illness (stroke/ peripheral artery disease/ carotid artery disease etc.)?
Once you tell me these details, I will discuss your lipid profile too.
Sincerely
sukhvinder XXXXXXX

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Dear Sir
Thanks for details.

1. If you do not have high blood pressure and diabetes, then your target LDL level is 160 mg%. Your actual level is 161 which is just borderline. In fact a trial of life style modification without any medicines can be given in your case. Medicines may be started only if repeat lipid profile (after 12 weeks) also shows higher LDL levels. (You should not stop taking 'Atorva' on your own. Please discuss with your physician first.)

2. Life style modifications for lowering cholesterol include low fat diet (avoid saturated fats , used refined oils/ olive oil only that too in minimum quantity), keep your weight under control (Ideally body mass index (BMI) should be ~23, BMI is weight in kilograms divided by height in meters again divided by height in meters {WT in kg/square of Height in meters}), Do daily brisk walk {In consultation with your cardiologist}. Avoid excess of sweets/ fried items/ oily foods.

3. Ciplar is given for your pain chest (which your cardiologist thinks is due to MVP). It is not given in this dose for hypertension. No, this is too low a dose of Ciplar to cause major side effects. Still if there is any problem, please tell your doctor.

Hope it is clear now.
Feel free if there is anything else.

Sincerely
Sukhvinder XXXXXXX

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