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2D Echo Diagnosis please...

Hello,

My Husband recently went for his one yr checkup where our doctor runs a EKG.  He noticed that the EKG came back slightly different in comparison to last yrs so he sent him for a Echo.  He just got the results back and all was good except it states at the bottom "Traces of mitral and pulmonic insufficiency".  Our doctor told us it was nothing to worry about.  My husband is 30 yrs old and has no heart disease in his family, how could he have this?  What does this mean?

Thank you!
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Avatar universal
It is not entirely uncommon to make a career change at his age.  Actually the statistics say that those people graduating college now can expect to have an average of 3 careers in their lifetimes (not JOBS, CAREERS), while the average number of jobs is way past that, probably at least 10+.  I'm 32 and I've lost count of all the jobs I've had at this point!  So, he should seriously consider this.  

Given the way the world is going with terrorism, the high price of oil, world political landscape uncertain, the rising cost of healthcare and its increasing % of total GDP, and the falling value of the dollar against other currencies (i.e. the Euro) I think the financial markets will be more volatile than ever for the coming decades (which equals what would be the vast majority of your husband's career).  So, what this will equate to will be years of headaches unless your husband becomes more resilient to these ups and downs (which is sometimes going against human nature).  That's why so many people have put more money into their homes as opposed to the markets because of this volatility and post the the internet bubble bursting in the late 90s and post 9/11.  And now the housing situation is a complete disaster (and I'm using very mild words here!).  A lot of people are actually going back to put their money in precious metals, government bonds (even this is scary!), and who knows, the way things are going it probably wouldn't hurt to stuff some dollars under your mattress!  Do you realize for that the first time in history this year that the national savings rate went into negative territory?  Where are people going to get money to invest if they can't even pay off their credit cards or can't afford to pay for gas to get to work?  Luckily it hasn't gotten that bad, but it is possible.  I bet a few years ago, no one thought oil per barrel would be pushing $100.00.  

Well, I hate to drop this "the world is falling" scenario on you, but I would be doing an injustice if I were to sugar-coat this.  I do a ton of reading from many top sources, so I'm not making this stuff up, research it for yourself on Google or something.  Knowledge is power!  You and your husband should prepare yourself for the future now.  You can succeed in this environment but you need to be smart, aware and have good tactics and versatility (and a lot of it) doesn't hurt either.  

You are not thinking crazy in my opinion, you have valid concerns.  At least you are worried for your husband.  There are unfortunately some women who would let their husband work themselves to death to get them those huge diamond earrings and not miss a second of sleep in the meantime.  He is lucky you are not like that.  It is good you have these concerns and you should.  

You know, Erica, everything happens for a reason, perhaps maybe this little "blip" on your husbands EKG is a sign that it's time for a change.  I don't know if you believe in a higher power, but I believe that there is something bigger than us and that he or she sends us messages in very subtle ways.  
This exchange has been a pleasure.

***Email address removed by MedHelp***
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Avatar universal
Hi Erica,

Thanks for such nice feedback.  It has been very interesting chatting with you as well--- I so often deal with patients very elder (80+) that's it's nice to help someone more in my age group that I have a closer connection to.  I don't think some of our elders appreciate how difficult things are for us (in our generation trying to make it).  

Yes being a financial advisor can be very stressful (I can't think of many jobs that are more stressful), especially now the way the market is and the mortgage crisis fallout.  I have an uncle that is a senior broker/advisor and although he's made consistent returns for his clients, now they are giving him the 3rd degree now that the markets are taking a downturn and seeing their returns dwindle.  But, that's the nature of the beast in the financial world and is why I decided to get out of that field--- the ups and downs too much for me.  The financial rewards are attractive, but at what cost?  I did a few internships with major financial institutions while attending college in New York City, but seeing the craziness of it all and some personalities I didn't click with, I knew it was not for me and changed my major to marketing (this was 6 years before I got into the echo field).  Sometimes, yeah I wonder, I could have been making "X" more dollars, but when I hear stories like your husbands, I hate to say, it makes me think that the change I made was the right things to do--- that's not to say that this field is without stress.  Certainly after a day dealing with very sick and frail 80 year olds takes its toll, but at least I can leave and know that that's that, the day is over and those cases are behind me.  It's another story when you're calling hundreds of people all day trying to get a lead, you come up with nill, then the next day you have to start that cycle all over again.....even the most iron-willed person will feel a bit defeated.  

I'm surprised your husband is in the financial field if his personality is to get nervous quick because in that field you really need to be a cool customer and maybe that's why he's feeling the way he's feeling.  There's a chance that his personality is just not a good fit for his career choice.  The professional career counselors say that matching your personality to the job is one of the key factors to take into account when choosing a career.  Perhaps he like the financial prospects of the field but didn't take into account how things would really be day to day for him---a trap, I'm sure thousands of people in the field have fallen into, and most people realize too late, that it's not for them and either do end up having a heart attack or stroke over it, or just suffer through decades just barely making it so they can pay their mortgages and maybe put their kids through college. I respect this of course, but just don't think it's the way to live a complete, happy life.  

So, what I advise is that he take a good step back and consider what is important in his life, which I assume is you and his health, his future.  Think about what he is doing (in his job) is accomplishing these things that he really wants.  See if maybe there's another route he can take to accomplish this.  He's still relatively young, so if he's going to make a change, now is the time.  He should maybe consider the insurance sector.  There is a sales component to this, but I don't think it's as cut-throat as investments because it has more of a product component (life insurance for example) and these come with investment products (i.e. annuitites) which maybe he has some experience with.  He should consider malpractice insurance, I have an uncle that did very well with that once he built up his client base.  A good company is John Hancock or Prudential.  

If he's really passionate about what he does now and does not want to make a change then he has to change his behavior (reaction to negative events in his field) and there are many routes to do this.  He could try certain mental exercises that are taught by books and mental-health professionals which teach one to react in a productive way to negative feedback instead of getting all stressed-out and downtrodden.  Many elite athletes, like Olympians use these techniques to overcome, say a poor performance (like you see a gymnast who really messes up to see her come back and then score a 10).  How do you think they do that-- do you think they're born with that (well maybe to a degree a fighting spirit) but really it's due to mental coaching which is provided by their actual coach or more likely these day a sports psychologist.  So, your husband can possibly find someone who does this, but more generally and I'm sure if he goes onto Amazon he can find dozens and dozens of tapes and DVDs which tout these techniques.  

Another route for him to go would be drugs which might calm him down a bit.  Some of them are Zoloft, Prozak, and Lexapro/Celexa.  Zoloft and Prozak are pretty strong and have, unfortunately, some pretty strong sexual side effects (not good!).  So, I've heard Lexapro or Celexa are a good way to go.  It takes several weeks for your brain to start absorbing it and for it to take effect, but over time the effects will be very noticeable to him.  

So, he has a few options he as noted above, 1.  Consider a career change that will offer the same or similar financial benefits minus the intense stress of the financial markets (the only way to avoid stress altogether is to live as a bum on the street and this would probably even involve stress at least physical stress!).  2.  Change his behavior and reaction to negative/stressful events by setting up mental defense tactics and offenses through a psychologist or self-help tools (i.e. books/videos)
3.  Try some type of mental medication that might calm him down

But, one thing is clear, he as to take some kind of action to change his situation.  If his job and related stress are already causing some health issues at 30, imagine what he will feel or what can happen by age 50.  Now is the time to take some progressive action.  And if you two want to start a family someday, he should definitely get these issues ironed out before you go down that path, because you compound a new baby into the equation and his stress level is going to go through the roof and that's not good for you, the baby, or him.  

-------cont'd on next post------------------------------------cont'd next post-------------------------------------------------
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Avatar universal
Again thank you so much for your thoughtful answers.  I honestly think it is stress as well.  He is a financial advisor so he has a very stressful job.  Plus he is the type that gets nervous quick and starts thinking the worst.  I think he is thinking that the test results have something to do with the feeling he has on occasion.  Sometimes I think your mind can plan tricks on you.  Its not like a chest pain more like just a slight tightness or discomfort.  He is not a smoker nor a heavy drinker (only on occasion) another thing is he just recently started doing regular excerices (treadmill and light weight training) maybe this has something to do with it.  We are pretty open in our relationship so I honestly think its work thats troubling him.  Our relationship is great and we have no children yet.  He is going to the cardiologist on Thursday just to have him read the results - I think its to make him feel better.  I will keep you posted (if you dont mind).

You have been such a great help and wonderful to talk too.  I myself have a tendency to think crazy things (which is why I started this post) so you have brought me ease.

Regards,
Erica
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Avatar universal
Hi again,

The symptoms and tightness which you describe of what your husband feels is extremely general and non-specific that it makes it very hard (and would be even for a doc) to nail this to any one thing.

Given that this is not associated w/ chest pain, we can rule out a mild heart attack or coronary artery disease- either of these would be very apparent and would well be above a 5 (on a 1-10 pain scale/ 10 being most painful).  

I sometimes feel something similar to what you describe and my guess is that it is due to stress.  Has he been under a lot of stress lately related to his job/career, family issue, financial issues, your relationship?  When I'm under a lot of stress I sometimes feel a slight, but acute pain right under my breastbone- is this where he feels it?  It is usually following a stressful day/event and I never feel it when I am in a relaxed or calm state and I never feel it when I'm exercising- even when it is vigirous- so I don't worry too much about it and just try to live a calm life (this has taken some practice!).  Maybe your husband just needs to relax a little more.

As far as this being bad--- well pain is a way of the body telling us something-- so if he is feeling some discomfort, it is certainly not a good thing, but on the other hand you probably don't need to cal 911.  I would recommend he find more ways to relax- maintain regular exercise, eat healthy, do some type of deep breathing/meditation, also regular sex (of course with you) are good ways to maintain an even keel and might lessen this chest tightness.  

I highly doubt what he is feeling is due to the insufficiencies- more likely possible causes are chest congestion (is he a smoker?-- if he is, he really should stop right away or go on a program to quit).  Does he drink (alcohol) a lot, again he should cut down (limit it to 2 drinks per day).  Another possiblity of this is a pulled muscle (particularly pectoral muscle)-- does he do heavy weightlifting?  If he does, lay off the heavy weights for a few weeks (just do some easy push-ups) and see if he feels better.  

Another possiblilty is some blunt injury from the past.  Was he ever in a major car accident where he was injured or played football and was hit a lot?  

Again my suspicions is what he is feeling is similar to what I feel on occasion and I'm right around his age, just a few years older.  It's stressful in this time in our lives, we are trying to set-up our careers for the future, we are trying to set-up a secure financial future (at a trying economic time in our country), careers demand intensity with the speed of technology and everything, we are trying to juggle all this with our relationships/marriages, and also trying to enjoy life.  It's pretty tough for our generation--- things are just so expensive- even basic necessities and now the cost of fuel-- for a guy, if he's anything like me, wants to be a good provider and good husband, but it's hard to find the right solutions in this environment.  I've seen a few guys in our age group with the same concerns, and I think I'm beginning to see a trend.  

The best way you can probably help is be a good partner- what marriage is all about.  Ask him if anything is troubling him.  But, before you ask, make him stop what he is doing, have him shut off the computer, his cell phone, TV, etc. and sit face to face in your kitchen table or living room.  Make him comfortable, maybe get some coffee or tea for the two of you.  Then ask him.  Ask him if he's not told you about something that's troubling him and that's it's OK for him to tell you anything and that you will be as understanding as possible.  Tell him that you want to help him problem solve and what you can do to help.  Maybe he's trying to do everything and needs to delegate some things to you.  Ask him if he is happy with your marriage....has it met his expectations ( in terms of fulfillment, friendship, fun, interaction, and sexual satisfaction).  If not, what does he want more/less of.  What is it that has come up that is troubling him.  Maybe he's killing himself to make a ton of money and you really don't care about that and would be happy living more simple and would rather him not be so stressed.  Have you talked about having children?  Is there some conflict about this- whether you want kids or the timing or the related financial ramifications?  You need to take alll this into consideration.  Even if he wasn't having the chest pain you should discuss this regularly.  

Finally make sure he gets enough rest-- I know it's tough, but we adults need a good 8 hours a night.  One other suggestion is that if you have a TV in your bedroom, take it out, that's not healthy.  The bedroom should be for 2 things - sleeping and sex (and maybe some light reading).  

Well, hope this helps.  I'm sure you'll figure it out.  Stress is a part of life and we just need to find ways to manage it.  

Feel free to ask me anything else.  Good luck!

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Avatar universal
Thank you again. May I ask you one more thing.  My husband told me that he sometimes feels a slight discomfort in his chest, no palipatations or chest pain just a slight discomfort like a tightness. Does this relate to the insuffiencies?   If so is this bad?  
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Avatar universal
No problem, that's what I'm on here for, so people like you don't get stressed out worrying about nothing.  So, go on, enjoy your New Year and maybe go and make some babies (if that should be on your agenda)-- if not practice makes perfect :-)

Happy New Years to you and yours as well!

Take care.
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Avatar universal
Thank you so much for your comment!  I really appreciate your insight.  I have been worrying for days and feel better.  Thank you again and Happy New Year!
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Avatar universal
Hi emh1077,

You and your husband should not be worried.  Per your doc, trace mitral and pulmonic insufficiency (aka regurgitation), are not something to worry about.  They are almost routine findings in echocardiograms on both childrend and adults.  Almost all of us have some degree of pulmonic regurgitation (just a little leakage of the valve when it is closed and usually does not have any clinical significance).  I have performed thousands of echoes and 99% of them have some amount of mitral and/or pulmonic insufficiency.  It just might sound shocking at first given that most people are not aware of it, but talk to any cardiologist practicing for any decent amount of time and they will tell you the same thing.  

When doctors and researchers talk about a family history of heart disease they are usually referring to sclerosis of the coronary arteries or coronary artery disease which can severely restrict blood flow to the heart and can cause angina or eventually a heart attack.  This is good that your husband does not have a history of this.  As I mentioned, the meaning of a little bit of mitral and pulmonic insufficiency is nothing.....it's just a clinically insignificant finding.  The echo machines these days are just so sensitive that they can pick up just a few drops of blood flow leaking from the valve.  If it stays as trace the rest of his life he will be fine.  

The discrepancies in the 2 EKGs from last year to this year can be explained by the machine or the technician performing the exam, the placement of leads, if your husband moved at all during either readings, any caffeine he might have ingested prior to the test, etc., etc..  EKGs are very sensitive.

I think it's safe to say that he can resume with his life and normal activities and be just fine for many years to come.  Keep in mind that one of the heart's strenghts is that it's very resilient and can tolerate quite a bit.  A little insufficiency of the valves is definitely within the heart's ability to withstand without effecting its performance or operation.  

I have a little mitral regurgitation and can bench press 180 pounds (I weigh 160) and run a mile in about 6 minutes and do intense cardio sessions of at least 40 minutes and I know i've had it for many years.  

Chances are, you being female, you have some slight amount of mitral regurge and pulmonary insufficiency (PI) and I'm sure you're just fine.

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