Irregular Beating High LDL Levels Prosthetic Mitral and Aortic Valves

  I am a 45 year old male, and have prosthetic mitral and aortic valves as
  the result of surgery in 1991 stemming from bacterial endocarditis. I have
  always had some benign PVC's, however recently I experienced almost
  constant irregular beating.  In addition, I had some blood tests done in the
  last month with the results that my LDL or LDH reading (I'm not sure which
  it was)is around 1200 instead of being between 300 and 600.
  My GP became quite concerned with my ECG which showed a marked difference
  from previous rhythyms on other ECG's I have had.  He doesn't kow if there
  is any relationship to the elevated blood levels.  I saw a valve Doc who
  said neither the odd beating nor the high LDL level is a real issue.  I see
  a cardiologist in the next week or so, but am quite concerned, as I hear as
  well as feel the odd beating.  It has become intermittent over the last week
  but is still quite disconcerting.  I feel it while at rest and during exercise.
  Is it expected that my pattern of beating will change as a result of the
  metal valves?  Does the elevated blood work reflect what should be expected
  with 2 metal valves?  Should I continue my regular pattern of working out
  3 times a week, or should I slow this down?
  

[CCF Cardio MD - MTR]

Dear Dan, thank you for your question.  I suspect that you are having more PVC's to cause the irregular heart rhythm that you are having, but you may need to wear an ambulatory ECG monitor to determine what your rhythm exactly is before your physicians can decide what to do.  The lab value you mention is probably LDH which is a non-specific marker of inflammation.  An elevated LDH, alone, is usually nothing to worry about but this value has to be interpreted within a clinical context.  With two mechancical valves, your red blood cells are probably being lysed at a low, baseline level (a common occurrence) which could elevate your LDH level.  If your blood counts are normal, then this is nothing to worry about.  The normal LDL level is < 130 so I doubt you have an LDL level of 1200.  Most often, PVC's are benign and do not indicate an adverse prognosis (even in someone like yourself who has had a double valve replacement).  However, your physicians will have to determine the significance of PVC's in your case.  Common precipitants of PVC's that should be avoided include alcohol, tobacco, and caffeine.  I think you should discuss the issue of exercise with your own physicians, since I am unable to give specific advice in this forum.
I hope this information is useful. Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Feel free to write back with further questions. Good luck!
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