ECG Results from China - Advice Needed Please!

[Emmah81]

I currently live in China and am having problems communicating with doctors in regards to my heart problems... So I'm desperately hoping for some advice on this website!

I have been very tired, have awful chest pains every time I exercise (and often when I'm resting) I have trouble breathing when I lie down, my hands shake, I urinate excessively, I have fainted on a couple of occasions, and my heart regularly makes a very loud 'frog-like' sound.

I STUPIDLY ignored these symptoms for a long time because I thought they might be 'in my head'.

I had terrible chest pains last Thursday and decided to go to the local hospital specialized in heart problems... The first doctor told me I had a serious murmur and a mid and late systolic click... He was amazed that I hadn't been diagnosed before and sent me for an echo.

The doctor giving me the echo was also amazed. His English was not very good but he managed to ask me whether I had life insurance!!! : (

I was diagnosed with severe mitral insufficiency (regurgitation) and atrial fibrillation. They told me to return to England NOW for heart surgery... However, I am reluctant to return if I'm going to be told I don't need surgery for another year or so.

I have spoken to 3 docors since (all in China) and they all advise surgery within the next 6 months.

However... I'd really like some information from someone in the UK or US and I'm hoping that someone might be able to advise me based on the following information:

27yr old Female
140lbs
5ft7

IVSTd: 9.5mm
LVDd: 57mm
LVDs: 38mm
LVPWTd: 9.5mm
AoD: 30mm
LAD: 40mm
EF: 60-61%
PA: 0.7m/s
E: 0.8m/s
A: 0.5m/s
E/A: 1.6
Ao: 1.3m/s

I have researched and researched on the internet since but seem to be getting mixed messages.

Do I need to get back to the UK for surgery NOW?!? Or can I wait a year with very litle risk?

ANY advice would be sooooooooooooo gratefully received! I feel very cut-off from 'the real world' right now!

Thanks in advance,

Emma

[Cleveland Clinic]

The decision to proceed with mitral valve surgery is based on patient's symptoms and echo findings.  It is sometimes difficult to get a good assessment of symptoms, but we are typically interested in knowing about any shortness of breath, especially with exertion, any evidence of worsening exercise capacity (unable to exercise as much as in the past), exertional chest pain, etc.  When these symptoms come on, it is time to schedule the surgery.  The echo helps in the decision making process such that if the ejection fraction is less than 60% or the dimensions of the ventricle are greater than 40 to 45 mm in systole, it is also time for surgery.  Exercise stress testing is sometime helpful because it can give us a more objective assessment of your symptoms.  So, at this point, I think you need to see a cardiologist you feel comfortable with.  I think you should go back to England at this point and consider preparation for surgery.  Because the timing window for right time for MV surgery is very narrow, I would urge you not to post-pone anything at this point.