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Cardiovascular regurgitation
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Cardiovascular regurgitation

I am a 53 yr old female who has been morbidly obese most of my life.  I have periodically lost from 20 to over 145lbs at a time; it always comes back.  In college they found I have an enlarged heart.  A few years ago I began having 'pinching' feelings in my neck and chest; the dr said if I returned again she would send me to a psychiatrist.  I went to an ER, underwent a stress test with results in normal range.  That summer I noticed my ankles began to swell, the following summer just under my knee/inner I began developing swollen lumps which are becoming larger and hurt when I walk.  My new dr said it was hereditory (fat) I told him it comes and goes.  A few months ago I began with the pinching and being woken up by loss of breath again.  My dr ignored me.  Again at an ER after a particulary difficult night I was given a CT and told all was ok but to follow up with an echocardiogram.  After waiting 2 mo. for an appointment the dr had to send me.  The results are:Left ventricular systolic function is normal; there is LV diastolic dysfunction; there is no evidence of mitral valve prolapse;there is no mitral valve stenosis; there is mild mitral regurgitation; there is mild tricuspid regurgitation; there is no pericardial effusion.
   The dr wanted me to go in to review the results but dropped my insurance.  After calling several times the nurse said I had a little leakage but that comes with age, bye.
   Unfortunately obese people fall in the catagory of drug users and seniors; it is rare a dr will take interest in us, they do not understand the turmoil we live in and how we long to live among the normal and be healthy.  So I am reaching out to find out what I should and should not do.  The internet states this never gets better just worse and I will eventually die from it.  Is this true, how bad is it, can I exercise (that's what started the chest pains) what are the do's and don'ts?  Can you help me or send me somewhere where I can gather accurate information so I can take care of myself; I am very frightened.
   Thank you so very much for your time.  I hope you have a very good and bright day!
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It sure looks like people are blowing you off. If you have a diastolic dysfunction, you have a problem, plain and simple. You need to see a cardiologist and find out exactly what the problem is so that you can be treated. The dystolic dysfunction can be caused by a Hypertrophic form of Cardiomyopathy and this is a serious form of heart disease. Hasn't anyone sent you to be seen by a cardiologist? You should not be taking care of yourself; you need to be seen by a doctor. What you have read on the internet is true, ultimately patients face a transplant, but that could be literally years down the road and a lot can happen in that time frame. As far as exercising goes, I would stay away from heavy exercise until you see a cardiologist.
Take care
Thanks for writing to the forum!
“Diastolic dysfunction refers to an abnormality in the heart's (i.e., left ventricle's) filling during diastole. Diastole is that phase of the cardiac cycle when the heart (i.e. ventricle) is not contracting but is actually relaxed and filling with blood that is being returned to it, either from the body (into right ventricle) or from the lungs (into left ventricle).
Some causes of left ventricular stiffening include:
• high blood pressure (i.e. hypertension, where, as a result of left ventricular muscle hypertrophy to deal with the high pressure, the left ventricle has become stiff)
• aortic stenosis of any cause (here as with hypertension, the ventricular muscle has hypertrophied and thence become stiff, as a result of the increased pressure load placed on it by the stenosis)
• scarred heart muscle (e.g. occurring after a heart attack) (scars are relatively stiff)
• diabetes (stiffening occurs presumably as a result of glycosylation of heart muscle)
• severe systolic dysfunction that has led to ventricular dilation (i.e when the ventricle has been stretched to a certain point, any further attempt to stretch it more, as by blood trying to enter it from the left atrium, meets with increased resistance - it has become stiff
• reversible stiffening as can occur during periods of cardiac ischemia” Refer:

Consult another cardiologist immediately. Also enroll under a good dietician and physical trainer and try to lose weight. However do this only when you get a green signal from a cardiologist. If going to a cardiologist is not possible directly then go through your PCP.
Hope this helps. It is difficult to comment beyond this at this stage. Please let me know if there is any thing else and do keep me posted. Take care!
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