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Suggest treatment for mitral valve prolapse and worsened mitral regurgitation

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Posted on Thu, 28 May 2015
Question: hello,
i drink 1 cup of coffee in the morning with milk to wake me up.
2011 findings :mild regurgitation of tricuspis valve.EF 55-65% .Mitral valve had asystolic bowing of the anterior leaflet,without evidence of prolapse. At this time my complain was dizziness,being tired. 2014 i went back to the doctor,feeling exhausted,out of breath,tired,more then usual.I also get anxious,angry,or just weird feelings,i can hear and feel my heart beat in my stomach or in my troat,i get the feeling it is chocking me and the burst ,and opends up.I developed dry cough,couldn't inhale enough,and the burping spells for hours. 2014 cardio findings : EF 74% , mild/moderate mitral regugitation,moderate mitral valve leaflet thickening,mild prolapse of mitral valve leaflet.says might need TEE ( i am not sure what it is) .Mild tricuspid regugitation.Trace of pulmonic regurgitation. Is this getting worse? I am 39,130Lb.I gained first time in my life 10lb in 4 months.I think i eat less then i used to.but gained.My
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Answered by Dr. Ilir Sharka (44 minutes later)
Brief Answer:
I would explain about your situation as follows:

Detailed Answer:

Hello!

Thank you for asking on HCM!

I understand your concern, and would like to explain that your primary disorder is mitral valve prolapse. I don't know if your first cardiac ultrasound was carefully performed (I think so), but actually seems that mitral regurgitation (which is often an associated finding of mitral valve prolapse), have progressed and worsened.

All your prescribed complains (anxiety, dry cough, breathing problems, etc), seems to be related to this clinical scenario.

The good thing of this history is that your global EF (left ventricular ejection fraction) is normal, but probably that exaggerated weight gain in 4 months may raise suspicion about excess fluid retention. At this point a pulmonary artery systolic pressure (measure by cardiac echo) should be re-evaluated carefully (you didn't mentioned on your prescription its value).

Mild tricuspid regurgitation and trace pulmonic regurgitation are not a problem; as they are encountered frequently in clinical practice and are considered normal findings. But the important point is pulmonary artery systolic pressure value.

The kye point of this history to be further evaluated is mitral regurgitation. TEE (transesophageal echocardiography) is necessary to evaluate more accurately mitral valve morphology and the severity of regurgitation.

Correctly quantifying the mitral regurgitation severity would give rise to the appropriate management strategy. This means the meticulous scheduled follow ups regimem by periodic cardiac ultrasound (to quantify mitral regurgitation progression), to better decide medication regimen, and if indications are met to decide the right time of surgical correction (if ever would be necessary).

Meanwhile, I would recommend you never to forget prophylactic antibiotics strategy for endocarditis, during any periprocedural invasive interventions periods.

Just discuss wit hyour doctor about the mentioned issues.

Hope to have been helpful to you.

Feel free to ask me whenever you need. Greetings! Dr. Iliri


Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Answered by
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Dr. Ilir Sharka

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Practicing since :2001

Answered : 8724 Questions

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Suggest treatment for mitral valve prolapse and worsened mitral regurgitation

Brief Answer: I would explain about your situation as follows: Detailed Answer: Hello! Thank you for asking on HCM! I understand your concern, and would like to explain that your primary disorder is mitral valve prolapse. I don't know if your first cardiac ultrasound was carefully performed (I think so), but actually seems that mitral regurgitation (which is often an associated finding of mitral valve prolapse), have progressed and worsened. All your prescribed complains (anxiety, dry cough, breathing problems, etc), seems to be related to this clinical scenario. The good thing of this history is that your global EF (left ventricular ejection fraction) is normal, but probably that exaggerated weight gain in 4 months may raise suspicion about excess fluid retention. At this point a pulmonary artery systolic pressure (measure by cardiac echo) should be re-evaluated carefully (you didn't mentioned on your prescription its value). Mild tricuspid regurgitation and trace pulmonic regurgitation are not a problem; as they are encountered frequently in clinical practice and are considered normal findings. But the important point is pulmonary artery systolic pressure value. The kye point of this history to be further evaluated is mitral regurgitation. TEE (transesophageal echocardiography) is necessary to evaluate more accurately mitral valve morphology and the severity of regurgitation. Correctly quantifying the mitral regurgitation severity would give rise to the appropriate management strategy. This means the meticulous scheduled follow ups regimem by periodic cardiac ultrasound (to quantify mitral regurgitation progression), to better decide medication regimen, and if indications are met to decide the right time of surgical correction (if ever would be necessary). Meanwhile, I would recommend you never to forget prophylactic antibiotics strategy for endocarditis, during any periprocedural invasive interventions periods. Just discuss wit hyour doctor about the mentioned issues. Hope to have been helpful to you. Feel free to ask me whenever you need. Greetings! Dr. Iliri