Hi—49-yr-old wmn who needs advice. Murmur at birth; heart cath age 14. Mild pulmonic valvular stenosis. Syncope at 15.
At 24: MVP on echo. No stenosis seen. Put on beta blocker.
At 29: Possible TIA due to BC pills. Started ASA, stay on beta blocker (10 yrs.)
34: Echo: MVP, slightly thickened mitral leaflets, mild mitral regurg. No stenosis.
47: Echo: nodule on anterior mitral leaflet. Mild tricusp regurg, mild mitral regurg, “poss. hyperdynamic state.” No stenosis noted.
49: 48-hr. Holter: heart rate 45-150; 5 ventric ectopics, 95 supraventric ectopics including atrial couplets.
Recent echo: mild mitral regurg, mild tricuspid regurg, mild pulmonary insuff. Mildly thickened anterior MV leaflet at coadaption point. No RV hypertrophy; no mitral stenosis (no comment on presence of pulm. stenosis). LEF 70%. Peak estimated RV systolic pressure from tricuspid valve regurgitant velocity 25.2 mmHg. Elevated aortic velocities; aortic valve cusps normal & aortic valve structure normal. IVC was 2.1 cm, but collapsed with inspiration. Left atrium at upper limits of norm. (3.66 cm two years ago; 4.01 cm in July 07).
Grandma died SCD at 51, uncle survived MI in his 50s. Dad (81) atrial fib, mod./ severe aortic stenosis, CHF. Dad's brother has atrial fib.
Questions: 1. Though conditions are mild (mitral regurg, tricuspid regurg, pulm. insufficiency), because some (all?) have been present a long time &/or since birth, are they increasing size of lft. atrium? Could this be a mismeasurement?
2. Tried beta blockers recently for palps, but pulse went low as did BP and felt fatigued, even on half a 25 mg. pill. Are betablockers advised, to slow down velocities? Would another medication be better? (Tried 2 diff. types of BB recently; bushed with both)
3. Are these velocities of concern?
Thanks!