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Aortic Regurgitation
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Aortic Regurgitation

Thank you for making this forum available!  I am a 32-year-old male who just had an echo.  The technician said I had a slight murmur, the cardiologist said I was normal (but to get another echo in 3-4 years if I wanted), and my primary care doctor said I should be concerned.  So, naturally, I'm confused and worried.  Here is what my echo reads:  The Color Doppler reveals an aortic systolic jet of .9 m/sec.  Antegrade flow across mitral valve is normal.  Trace-to-mild mitral regurge, trace-to-mild aortic regurge. trace tricupsid regurge, and trace pulmonic regurge.  Now, the IMPRESSION reads the same EXCEPT for aortic regurge, which is described as mild-to-moderate.  I am confused why the Doppler reads trace-to-mild and the impression reads mild-to-moderate.  From what I've read on here, trace/mild is not a big deal.  But mild-to-moderate is.  My MD suggested antibiotics for dental visits, etc., and seemed to take the mild-to-moderate very seriously.  Also, my EF was 55%.  
I don't smoke, don't drink, am not overweight, have 120/80 BP, resting heart rate of 65 or so.  

I have a few questions:  
1.  Which is the correct finding:  the Doppler or the Impression?
2.  If the impression is correct, what is the likelihood of mild-to-moderate degenerating to severe/congestive heart failure?  How much can my lifestyle (BP, lower resting heart rate, no diabetes, etc.) retard that degeneration?  
3.  My EF is not stellar.  55% sounds borderline.  I have not been running this past year.  Will my EF go up as I run more and strengthen my heart?  Do EF's diminish with age? Thanks!
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cjpmiller,

Thanks for your questions.

Sounds like your doctors need to converse with one another!

(1) I don't know which reading was right.  The only way for me to know would be to look at the echo.

(2) The likelihood of the aortic regurgitation leading to heart failure in a person with mild-moderate regurgitation is unknown, but probably low.  Some experts would suggest that if a bicuspid valve is at the root of the problem then perhaps 33%-50% would eventually require surgery.  In patients with moderate to severe regurgitation who have no symptoms, the rate of progression to symptoms (and thus surgery) is approximately 2-5% per year.

At the CCF, for patients with greater than mild regurgitation, we look at the Aorta to see if a bicuspid valve is present or if their is aortic dilation.  If neither are present, then we check labs to see if the person has an underlying disease of the vessels.  Regular blood pressure checks and exams are performed.

(3) The effect of age and exercise on the heart is variable and difficult to predict.  Discuss this issue with your doctor in the context of the rest of your history.

The bottom line is that your doctors need to decide the severity of the regurgitation and communicate this with you.  Good luck.

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