Question Title: curious about my Echo report

I am 34year old female, G4P2. Fam. hx. is positive for my father
deceased at age 53 from several aMI's and an embolic CVA - first MI at age 37.
I became obese during first pregnancy and remained 180-200 lbs (64inches tall)
for several years. Then, I took Phen-Fen forabout 9months, tho usually at half my prescribed
doses.
I began to have a vague sense of pressure/dull ache/breathless sensation
in my chest about 6months ago. I recently had an Echo which revealed moderate
aortic insufficiency and mild mitral regurgitation, along with normal valves
(no proplapse) and normal chamber dimensions and "vigorous" contractility. My
EF is 53%. (the lower normal limit). I can find no mention of pulmonary pressures
or flows. My internal med doc reassures me that I don't have PPH.

1) What pressures or other values on my echo report demonstrate that I do not have PPH?

2) The report incorrectly lists my gender and does not at all include my height, weight or
age. Would the "normals" be different because of this?

3) What signs/symptoms will indicate when valvular repair is appropriate?

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Dear Mary, thank you for your question. I'll answer your questions in order.

1) If you had PPH, your echo should demonstrate elevated right heart
pressures which would be manifested as tricuspid valve regurgitation. When
the pulmonary artery pressures increase, the pressure is transmitted back
to the right ventricle. Since the RV is not used to elevated pressures, it
uses the tricuspid valve as a "pop-off" valve to reduce the intraventriculare
pressure. Tricuspid regurgitation results. Thus, it appears that PPH is
not present in your case.

2) I'm not sure what you are referring to in terms of "normals."
Do you mean normal valves or normal ventricular contractility? In either
case, the definition of normal valves and ventricles doesn't change with
age, sex, gender, etc.

3) With aortic regurgitation, echo findings are generally used to determine
when aortic valve repair or replacement are needed. Most cardiologists
agree that surgical intervention is needed when the ejection fraction
starts to decrease from normal or when the internal dimensions of the left
ventricle increase in size. Usually, most patients are asymptomatic at this
time but if mild symptoms of congestive heart failure occur (shortness of
breath with moderate exertion like walking up a few flights of stairs,
shortness of breath with lying supine or during the middle of the night,
or swelling of the lower legs), then surgical intervention should also be
done. Patients with chronic aortic regurgitation usually are followed
with echocardiograms every 6 months and with regular visits to a
cardiologist. Valve repair or replacement generally is not needed until
the aortic regurgitation becomes severe. Also, you should receive
antibiotics with any dental procedures and usually with any other invasive
procedures.

I hope you find this information useful. Information provided in the heart
forum is for general purposes only. Specific diagnoses and therapies can
only be provided by your physician.

THank you very much. I am happy to supply any additional information ot help you answer my questions.

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