Ambiguous MVP diagnosis

Hi,

I have been reading posts on this site for years, but only recently have I begun to contribute.  

In Jan. 2006, I had an echo done for suspected MVP (though no click/murmur on auscultation).  The results indicated "borderline posterior leaflet prolapse" and "leaflet fibrosis" with "mild mitral regurgitation".

I saw a different cardiologist later in the year for a history of PSVT that has been managed well.  I asked him about the vague MVP diagnosis by the other cardiologist (at a different center) reading my Jan. 2006 echo.  He said he would have one of his associates review the copy of the echo I gave him.  They found "posterior leaflet prolapse" with "no thickening" and "no mitral regurgitation".  So which is it??? I do not understand why the inconsistencies in readings.  

Anyone have any ideas?  On the acc.org website in the below link that "mild" cases should not be diagnosed as MVP and that "mild or moderate billowing of non-thickened leaflets are probably normal".  So why, then, would I get a "near diagnosis" with these findings.  

Link to ACC reference below:

http://www.acc.org/qualityandscience/clinical/guidelines/valvular/jac5929fla16.htm#D

I am glad for this forum!!

[mary2]

MVP diagnosis is made from ECHO. If mitral valve leaflet prolapses more than 2 mm then MVP diagnosis is made. If there is lets say 1 mm prolaps, often docs mention mild MVP.
Clinically that does not mean a lot since you do not have MR and your leaflets are not thickened. You do not need antibiotic prophylaxis prior to dental procedures and likely the valve will never be an issue for you.
Hope that helps

[dave3422]

Thank you for the input.  I was having a hard time understanding why the inconsistent readings.  Why do you think one cardiologist ready my ECHO would use the term "borderline" and another would leave the word "borderline" out?

And why might one see "thickening or fibrosis" and mitral regurgitation and the other see no thickening and no MR.

I'm confused?  Should I be concerned?

[mary2]

The echo reading is quite subjective. Many statements are made on visual estimation. So report will differ from one to another cardiologist.
Generally, MVP should be diagnosed only if it meets criteria. Usually leaflet are also thickend if MVP is present since the mechanism of MVP in myxomatous degeneration of mitral valve. Same is true to thickening of mitral valve leaflet, one may mention mild thinkening another one not (subjectivity of echo). Mild MR is normal at any age.
I don't think you need to worry.  Many people carry erroneous diagnosis of MVP due to vague abnormalities on the echos. I don't think you will ever have an issue with the valve since the degree of abnormality is minimal or nonexistent.
Hope this helps

[dave3422]

Thank you!  Your explanation sounds thoughtful and knowledgable.  Out of curiosity, what is your background?  Are you in the medical field?

Thanks again!

[mary2]

Yes