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Heart Disease (Expert Forum)
Atrial Fibrillation and Mitral Regurgitation.
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Atrial Fibrillation and Mitral Regurgitation.
by Dr. Erik, Nov 26, 2001 12:00AM
Dear Doctor-
In my previous post about Atrial Fibrillation/Mitral Regurgitation, I failed to mention that I have been experiencing
for a least 10 years, very short episodes of what I feel was also Atrial Fibrillation. They usually only lasted 10-15 seconds at a time. Doctors were never able to catch them on a holter, stress test or EKG until 4 weeks ago when I had a four hour episode of A-Fib. My magnesium was low and I had just drank two glasses of red wine before this episode.
I had a Stress-Echo one week after the episode of A-Fib and everything was normal except for Mild Mitral Regurgitaion. He clasified it as 1+. Ironically, I just had a stress echo about six months ago, and it was completely normal with no Mitral Regrgitation. Also, I had a couple of Echos over the past ten years during these very short episodes of what I also feel was A-Fib(it felt exactly the same as my recent episode). These echos were also completely normal with no Mital Regurgitation. My questions are:
1) Is it possible for the Mitral Regurgitation to have come on so fast in the last six months?
2) Is it possible that my Mitral Regurgitation is not always present since it didn't show up on my previous echo six months ago or on any of the echos throughout the last 10 years?
3)Do you think my Doctor is right not to worry about repairing my Mitral Valve for a long time( he said 60 years)?
4) Based on the information from this post and my previous post, coud you give me your take on what is going on with my heart?
Thank you very much for your help!
In my previous post about Atrial Fibrillation/Mitral Regurgitation, I failed to mention that I have been experiencing
for a least 10 years, very short episodes of what I feel was also Atrial Fibrillation. They usually only lasted 10-15 seconds at a time. Doctors were never able to catch them on a holter, stress test or EKG until 4 weeks ago when I had a four hour episode of A-Fib. My magnesium was low and I had just drank two glasses of red wine before this episode.
I had a Stress-Echo one week after the episode of A-Fib and everything was normal except for Mild Mitral Regurgitaion. He clasified it as 1+. Ironically, I just had a stress echo about six months ago, and it was completely normal with no Mitral Regrgitation. Also, I had a couple of Echos over the past ten years during these very short episodes of what I also feel was A-Fib(it felt exactly the same as my recent episode). These echos were also completely normal with no Mital Regurgitation. My questions are:
1) Is it possible for the Mitral Regurgitation to have come on so fast in the last six months?
2) Is it possible that my Mitral Regurgitation is not always present since it didn't show up on my previous echo six months ago or on any of the echos throughout the last 10 years?
3)Do you think my Doctor is right not to worry about repairing my Mitral Valve for a long time( he said 60 years)?
4) Based on the information from this post and my previous post, coud you give me your take on what is going on with my heart?
Thank you very much for your help!
Doctor's Answer
by CCF-M.D.-CRC, Nov 26, 2001 12:00AM
Dear erik,
It is possible that the regurgitation has progressed to the point it is now present or it may have been present 6 months ago but the loading conditions of the heart were different and it was not detected. In general mild regurgitation is not a cause for concern. The only reason I would be slightly more concerned in your case is because of the atrial fibrillation. One cause of afib is severe mitral regurgitation so this must be excluded. I would consider a transesophageal echocardiogram to better evaluate the valve and exclude worse regurgitation then seen on the surface echo. If this is negative then I would not worry about the valve and treat the afib.
It is possible that the regurgitation has progressed to the point it is now present or it may have been present 6 months ago but the loading conditions of the heart were different and it was not detected. In general mild regurgitation is not a cause for concern. The only reason I would be slightly more concerned in your case is because of the atrial fibrillation. One cause of afib is severe mitral regurgitation so this must be excluded. I would consider a transesophageal echocardiogram to better evaluate the valve and exclude worse regurgitation then seen on the surface echo. If this is negative then I would not worry about the valve and treat the afib.
I.E., If I have a PVC I think it "feels" lighter in my chest. But sometimes I'll have a "ectopic beat/flub" and it will "feel" heavier?? Does this make any sense to anyone?
SO, is the "heavier" feeling a PAC, A-fib or PVC?
The "heavier flub" seems to feel like a "roll" (more left to right feeling in heart)in my chest [and lasts about 3-5 secs.] as opposed to a "lighter flub" that feels like, a "paused beat" followed by a couple quick beats and back to normal.
wilson-wilson
Arthur, you said..."These things can occur in high frequency and simulate an AF situation...however, if a normal background rythym appears to continue then it's not AF."
I used to have elevated BPM (maybe up to 100-120) after the PVC [now that I know the difference..the ROLL] because of sudden anxiety rush. But now after reading all y'alls way of handling them I just go "Ok, let it pass" and it does in a couple of seconds and everything is normal. But I've NEVER, (underline NEVER), had anything approaching 300BPM...wow!
I guess I'm kinda lucky then....'cause most of mine must be the "PAC" [light blips] kind.
But when I have the "movement kind" they are usually the PVC [roll] kind.
wilson-wilson