Echo Changes.

[momplus3]

Great forum and thank you for your time. MVP w/dysautonomia dx yeaers ago. Echos performed every 2-3 years. Shows slight posterior bulging in apical view, does not meet current strict criteria for MVP. Antibiotics prior dental care. Echos have shown previously trace mitral valve regurgitation and trace tricuspid regurgitation(though this does not show on every echo). Last echo performed in fall of 03. Everything remained the same. Question is how common is it for the leakage to worsen over time in either/both valves? Can the leakage appear differently on a regular echo vs a stress echo? Does hydration play a factor? Can the results be interperted differently by different physicians? Last echo was stress echo and showed mitral regurgitation.(No trace or other wording given. Physician stated everything the same. In a structurally normal heart would you say the probabilty of the leakage staying basically the same is good?  Does increase of pvc's or pac's indicate a worsening of the condition or does one not have anything to do with the other. I tend to suffer from the pvc,pac and adrenaline symptoms. I read someone elses post regarding the similar issues but wanted to present my case and look for reassurance.

Thank you once again!

[Kristin391]

Why would dehydration cause an increase in regurgitation?   Along that line, why does the jugular vein distension increase and decrease with ventilation.  I have noted that if I am not taking enough diuretics, I have very persistent and huge jugular vein distensions.  When I take adequate amounts of diuretics to get rid of the extra volumes, my jugular vein distensions will decrease with inhalation and increase during exhalation.  Why does this happen?  Does this correlate with the increasein regurgitation that may exists with dehydration?  Is there any signifiance to that? I find this very perplexing.

[Kristin391]

Why would dehydration cause an increase in regurgitation?   Along that line, why does the jugular vein distension increase and decrease with ventilation.  I have noted that if I am not taking enough diuretics, I have very persistent and huge jugular vein distensions.  When I take adequate amounts of diuretics to get rid of the extra volumes, my jugular vein distensions will decrease with inhalation and increase during exhalation.  Why does this happen?  Does this correlate with the increasein regurgitation that may exists with dehydration?  Is there any signifiance to that? I find this very perplexing.

[CCF-M.D.-RCJ]

Momplus3,

Thanks for the post, and thanks for the vote of confidence.

Q1:"how common is it for the leakage to worsen over time in either/both valves?"

If you have the process of myxomatous degeneration that leads to MVP, then the mitral valve may gradually begin to leak more with time, but given that you have no significant increase in the leakage to date, the chances are less for you that the valves will begin to leak more.

Q2:"Can the leakage appear differently on a regular echo vs a stress echo?"

The difference between the two types of echo is in the person, not the echo.  A regular echo is done on a resting person, a stress echo on an exercising person.  Yes, it is possible for exercise to make some valves leak more.

Q3:"Does hydration play a factor?"

Yes, it can in some circumstances.  Dehydration may lead to more leakage in some patients.

Q4:"Can the results be interperted differently by different physicians?"

Absolutely.

Q5:"Does increase of pvc's or pac's indicate a worsening of the condition or does one not have anything to do with the other."

It is possible that an increased leakage could lead to more PAC/PVC, but this is not a common or reliable finding.

Hope that helps.