Changes in heart murmur

[uptowngirl]

Hi.  Thank you for taking this question.  I appreciate you all and all the posters/commenters so much.

Quick background: Diagnosed with MVP--moderate,(20 years ago,very little change)mild MR,antibiotic prophylaxis, take beta blocker/Channel Blocker,annual echos, feel great, good health, don't smoke etc. My daddy had MV repair, did not go well, but is heavy smoker

My question is: regarding the click and murmur that the cardiologist hears.  They  always hear the click, however, the murmur can sometimes be faint and sometimes very distinct.  Why is this?  Also are heart murmurs graded?  For example the Dr. said at one of my visits "you have a level 2-3 murmur" or was he more likely referring to the place in the cycle of the heartbeat at which he heard it?

Thanks so much,
Uptown  

[Cleveland Clinic]

uptown,

thanks for the post.

Why is this?

Murmmers are caused by turbulent blood flow moving through the heart. Any thing that effects the lood flow such as variations in blood pressure, changing positions or even holding your breath can change the sound of the murmmer. I wouldn't worry too much about the quality of the murmmer. There are better ways to evaluate the valve then through listening to the murmmer. In fact, some of the most harsh murmmers are caused by mild changes in the valve because they cause the most turbulence.

Also are heart murmurs graded?

Yes. They are graded by the loudness of the sound and when in the cardiac cycle they occur.  Level or grade refers to the intensity of the sound. Systolic and diastolic refer to when in the cardiac cycle the murmmer occurs. Systolic means when the heart contracts, diastolic refers to relaxation.

good luck

[pms_barbie]

Sometimes they can hear my murmur sometimes they cant.  My dr said sometimes the murmur is more pronounced.  Like if your dehydrated .  The reg is graded from 1 to 4.  I have no idea if the amount it prolapses is graded or not.  Other than being labeled as mild or moderate.  I assume it probably is gradded also.  One time my cardiologist couldnt hear the murmur and had me do the valsalva manuever to try and hear the murmur.  He still couldnt hear it.

[uptowngirl]

Thanks Barbie.  That gives me good insight knowing others have encountered changes in the murmur sounds.
Uptown

[pms_barbie]

It always helps knowing your not riding in a boat alone....lol  I was thinking I was nuts because I had just been diagnosed with mvp.  The er dr heard it the week before echo confirmed it and the dr was like I dont hear anything.  I have supposidly had mine since birth so I couldnt understand why no other dr had picked up on it.    As you know I suffer from pvc's.  I broke my hand at work and was sent to their company dr.  He listened to my heart and said I had a slow heart beat.   Little did I know at the time I had to have been in bigeminy and just didnt know it.  So the whole pvc issue had been going on a while before I even knew it.  My aunt has a bad mitral valve and stays in bigeminy and never knows it.  I was floored when she told me that.  She is my aunt by marriage not a blood realative.  You said your dad had a repaire.  Is there any other realatives in your family with mvp?  No one in my family but  me has been diagnosed with such however my grandfather on my moms side had an enlarged heart.  I asked mom why its was enlarged she said they never looked into back then.  He lived to be 72 and didnt die from his heart.  So maybe he had something like mvp that caused his heart to enlarge.

[uptowngirl]

Hey Barbie,
Yes,it is good to know as you said "we're not in the boat alone".  I'm glad to know about your story.  I always appreciate hearing all the different histories people have to share on this forum.  
Thanks for responding about the level of murmurs, that did help clarify.
Yes, my grandpaw and daddy have had mitral valve issues.  Grandpaw has been deceased (1976). My sister has some troubles, mostly SVT, fainted once.  My daddy's the one I'm most concerned with. We're always fussin at him about the smoking issue.

Sorry to hear about the bigeminy episodes, can't say that I know exactly what that is.  Is it an abnormal heart rhythm?  I am familiar with A-fib.

I do believe the amount of prolapse of the mitral valve is graded.  At least on my echo reports they are  

You know FYI,my cardio told me that often MVP will skip a generation, so that could possibly be the issue, seeing that your grandpaw possible could have had it.  You've probably heard that before.

I was also first diagnosed in an unusual way.  I was taken to an urgent care with extreme shortness of breath, and the Dr. took a listen to my heart,did an ECG, and chest X-ray which were all abnormal. She was so kind and reassuring about the whole thing and she sent me to a cardiology group, which has been great.

Do you take any meds?  Do they seem to help with the PVC's?  How long ago did you find the forum?

Sincerely,
Uptown

[uptowngirl]

Thank you so much for your clarifying and specific response.  It provided me with more informed knowledge of the whole click-murmur scenario.
Uptown

[pms_barbie]

I think it was back in January when I found this orum.  My ep dr has given me a scrip of toprol but I havnt started it yet.  Trying to deal with the pvcs on my own.  For the most part my bogeminy is gone.  My ablation took me from 10000 pvcs a day to a 1000.  He said if they got bad again we would do another ablation.  Hopefully it wont.  You mentioned your daddy smoking hun I am in the same boat.  Last time I saw my ep dr he was on my case about smoking.  I must need a house to fall on my head....lol

[DottyCece]

Does anyone have experience with taking Torsimide (Demadex)?  Has anyone found that it causes dizziness?

[pms_barbie]

Hun sorry I cant help you out there.  I dont know what that drug is even for.  Is it listed as a side effect?  It may be worth talking to your dr about to see if they can adjust the dosage or maybe even give you a similar drug that wont cause that side effect.

[uptowngirl]

Hi DottyCece,
I believe Demadex is a  kind of diuretic, and I agree with barbie that talking to your Dr. about changing or lowering the dosage may help with the dizziness. Keep us posted on the outcome.

barbie, sure didn't mean to put anyone on a guilt trip about the smoking thing.  I know it's hard. We all got issues. I have my own.  It's just hard to see my daddy always getting scolded every time I took him to his appts. Sometimes the Drs. were even upset with me for not helping him give it up.

Uptown

[pms_barbie]

hun you didnt make me feel baad.  Thats an issue ive got to deal with sooner or later because if I dont it might deal with me first.:)

[SouthJ]

This is something I've been wondering for a long time and maybe someone here knows the answer. If after vigorous exercising you can see your pulse by watching the movement in your wrist, does this mean you have clear arteries? Following this logic, I am assuming that a pulse strong enough to cause a visible movement in the skin would mean that the blood flow through the arteries is very strong and unimpeded - hence very little plaque build up in the arteries that would make blood flow slower and more difficult. Does this make sense or am I barking up the wrong tree here?

[hankstar]

Usually when you arrive at a hospital and a good strong pulse in your wrist is detected, it is often referred to as having good volume and usually indicate a strong or good circulation. So you are not necessarily barking up the wrong tree, but please note it does not necessarily mean that you are completely free of coronary heart disease either, but it is usually a sign of good circulation.