18 year old w/ cardiac problems

[Jeri E]

My 18 year old son did his annual physical for football, the doctor immediatly referred us to a cardiologist.  As a paramedic I knew this wasn't good.  The cardiologist did an echo-cardiogram.  Her results were shocking to all of us.  My son has a mitral valve prolapse with regurgitation, as well as an enlarged myocardium and an ejection fraction of barley 50%.  My cardiologist stated that she has seen elderly males who have infarcted that have a better ejection fraction.  My questions are this.
1.  Could the Mitral valve prolapse be causing the problems with the enlargement and the poor ejection fraction.
2.  If so, what are the options of fixing this?  Will it be necessary to do a valve replacement to stop contiued damage?
3.  At 18 years old, with these problems, what sort of quality of life can he expect long term?

I am trying to get other opinions, thank you for your time.

Jeri E.  Pinetop, AZ

[pbanders]

You need a second opinion. Get to Phoenix and see a reputable cardiologist. Any cardiologist who would say what yours did about an EF of 50%, such that it scares the whole family, is not who you want to be seeing.

[Jack54]

Do you have an actual copy of the echo data? If not, you need to get one. You haven't given us enough information that is on that data sheet for anyone to really help you.

Myocardium means muscle of the heart. Which part of his heart is enlarged? How was the regurgitation flow rated, i.e. mild, moderate or severe? What terms were used to describe the prolapse? How many dimensions of the heart were borderline or above average?

The heart valves should be described with fairly lengthy detail.

Is your son overweight? What is his normal blood pressure and heart rate? How did his EKG look?

Whether or not his mitral valve is in need of repair or replacement, depends on the amount of regurgitant flow, and the general condition of his mitral valve. The regurge flow is backwards flow which is diverted from the brain and the rest of the body, and is pumped back into where it came from; the pulmonary vein in the lungs. If this backwards flow is bad enough your son will have symptoms such as fainting, pulmonary hypertension and an increased risk of pulmonary embolisms (PE=blood clots).

Due to you son's age, I would try to stay away from the CT heart scans due to the high ionizing radiation dose.  The next test that I would want, would be the TEE test (Trans-Esophageal Echocardiogram). This test produces excellent images of all 4 of the heart valves.

My very best to your son,

Jack

[GOCHRISTINE81]

if it makes you feel any better I am 22. I have mvp with regurg too. I just posted a quetion about
my ejection fraction also. it used to be 73% now only 56%. My doc has also recently found pac and pvc arrythmias, but says not to worry. we'll see. wish you well.

[often]

I am not sure about the mitral prolapse or the  enlargement.  An efof 50% is not that bad.  Normal is 55-65.  I had moderate regurg, enlarged heart and a 10% ef when I was first diagnosed with CHF.  There will  be more knowledgeable people who will know better the impace of the prolapse.  What kind of plan did the cardiologist come up with to treat your son....other than scaring the heck out  of you with  the comment about elderly males infarcting? If you are uncomfortable, by all means seek a second opinion.

BTW...with treatment, my ef is now  >50%, my heart is normal size, normal function and my regurg is mild....keep in mind most people have some mitral regurg.

[Jillejam]

A 50% EF isn't that low, that is about 90% on a scale of 100%....normal EF is usually 60.  I am sorry but I don't know much about mitral valves.  I wouldn't think that he would need surgery at EF of 50.  I would maybe get all your medical records and see another cardiologist.    Did your doctor say that he would need valve repair or replacement?  Did she put your son on meds?  I wouldn't put all my stock into echos, they don't always come out perfect.  Maybe a MRI or CT Scan of the heart might be another avenue to take, they are both noninvasive tests.  Good luck to both of you!

Jill