Leaky Valve

I learned this week that my breathlessness/tiredness/unable to breathe when lying down, palpitations, etc. are due to two leaky heart vales.  One of them the Mitral valve and not sure of the other as the doc asked me sarcastically why I wanted to know "Was I a doctor?"!  I have to have a treadmill test and then he is going to discuss medication.  I noticed that all the meds for heart disease usually lower blood pressure - I have a very low blood pressure and also developed asthma three years ago.  (I'm a 52 yr old female with ankylosing spondylosis)  Can I still go to exercise classes?  Sometimes I feel a little faint but need to exercise otherwise I become very stiff.  Thanks.

[Cleveland Clinic]

Typically aortic and mitral valves in patients with ankylosing spondylitis.  Mitral regurgitation and aortic stenosis with regurgitation are the common valve lesions.  The most important aspect of the disease follow up is your symptoms.  Put another way, if you are having a lot of symptroms that limit your physical activity, than exercise may not be the best thing for you.  Of couse if you can tolerate minor activity which allows your to stretch and keep your back from stiffening up, you should go ahead and continue to do so.  I am concerned that your blood pressure is low because that may be a sign that the valve disease is severe.  When the blood pressure is too low there arent't really too many meds that can be tried without developing hypotension.  You should definitely find out what valves are diseased and your physician should volunteer this information without any problems.  I don't know why your cardiologist acted that way.  Keep in mind, that if you don't feel comfortable with the current physician you could always go to see someone else.  Not all people where meant to get along well.  Maybe you need someone with a different style or different approach to patient care.  You should also have an echocardiogram if that hasn't been done yet.  Valvular disease in almost all cases requires some type of surgical intervention.  Medications are only used in the early stages to slow down the process.  Ultimately most patients need surgery.  There is also a specific window of opportunity when the surgery must be done in order to avoid complications.  This means that close follow up is essential.  

[aproverbs31woman]

I have airtic valvue disease that was diagnosed and I am a 59 year old female.  My cardiologist informed me mmediately after the ech that day and said that it needs to monitored and I go every 3 months, because I have others issues also which seems to be controlled by meds.  I was original given medicarion for the valvue problem and ended up in the hospital on 3 occasions because it was dropping my bp so low that I was passing out and actually did it int he hospital.  Once I was taken off the meds I was ok.  They usually wait for my bp to return to normal on its own and don't treat me again unless the bp goes back up.  I was told that with valvue disease you have to make sure that your bp stays down otherwise it does more damage.  Hope you feel better the heartMD gave you good advice

[Mia_1]

Thank you for your comments Dr.  I am going to change my consultant - I saw a Registrar and wasn't happy with his attitude.  One question please - what meds are used in the early stages?  I've been told I cannot have beta-blockers as I have asthma.  My heart was acting chaotically again this morning from 4.00 a.m. and I wasn't able to sleep.  It eventually tails off once I have been up a couple of hours.  Thank you.

[Cleveland Clinic]

It would be difficult for me to tell you which medications to use because I am not entire sure which of your valves is most affected.  One also has to consider patient's blood pressure and ejection fraction of the heart before starting any medications.  Sometimes, depending on the valve lesion, we may add on blood thinners to prevent the risk of stroke.  Sometimes, the disease has progressed pass the stage where we can add any medications and patients may have to go to surgery.  Therefore, it is not a simple thing and you have to have an experienced physician take care of you.  Also, the chaotic rhythm may mean many things.  Hopefully, it's just anxiety related.  Sometimes patients develop abnormal rhythms that typically aren't dangerous but may need to be treated.  Again, an experienced heart doctor will be able to handle all this without a problem.  

[Jillejam]

After you were converted did they run tests on your heart?  I had similar problems as yours except I was having VT and was electro converted in ER then shipped to a bigger hospital for further testing.  Have you seen a cardio doc?  or an EP cardio doc?  

[CBC0912]

I just turned 73 this  June. I hadn't noticed  any problems till just  after the 4th of July. My wife and  I  were visiting  my sister. I could not lay in bed at all. I  had to get up and sit on the couch in the front room. This went on for  the four days we were  there. The same thiing when  we got  home but now sleeping in seperate  beds. It seems  as  though  I didn't notice  the breathlessness for a  short  time but I certainly noticed the coughing. I thought my old asthma kicking up. I was given an EKG, Chest Xray and  blood test (later ECHO). To make a long story short it was found I had a regurgitating valve (Left Mitral). I just had an angiogram on the 7th of  Sept. in which only one Artery was found to have some blockage. So now it seems a repair job is in  order or a replacement of the valve. I'm not to anxious to go under the knife or jigsaw. I have no idea if the coughing or breathlessness will  improve.  I was in the hospital about 2 weeks ago for 2 days after being examined by a nurse /prac. It was to get fluid out faster than trying it at home. Since then I have 4 more meds. 1 of them being Coumadin. I guess the problem is I am not to enthused over the prospects. I have rapid heart beat also. Fribilating. I was shown the heart model and the valve. I seem to be dumber than a cement wall about this.Plus had SHL in right ear in December of 06 and looseing it in my left at a good clip. All my sleeping habits are down the  tube.

[Momto3]

Sorry to hear you are having a difficult time resting/sleeping.  A significantly leaky valve can turn your life upside down when you least expect it.  Has your doctor said you will need surgery?  If so, have you been evaluated for the surgery?  Any idea how bad the leak is?  They are usually graded 1-4, 1 being the least regurgitant (leaky).

I have 2 - 3+ mitral regurgitation and so far, I have not needed surgical intervention.  My doctor watches for any changes so I will have the chance at repair as opposed to replacement should the need arise.  

I hope your new medication helping with the rapid heartbeat.  Getting that under control may help you to feel better.    

Hope you are resting better.  Enjoy the day!

Connie

[Mrs Boge]

I currently have mild arotic insuffiency due to TOF (congenital heart defect).  I am 47 and have been quite blessed to not have any problems over the years other than surgery at age 9.   Lately I have been a little more winded and I have noticed that my diastolic blood pressure has been running low between 44-65.  My Systolic runs between 104-116.    I'm concerned that my low diastolic pressure means my arotic insuffiency is getting worse. Any comments would be greatly apprecaited.

[Momto3]

Do you have regular echos to keep an eye on the valve?

[rheslin01]

Hi I'm 28 yro male and was diagnosed with a bicuspid aortic valve with some inlargement in the aortic root around the valve.  I have played contact sports my entire life with no problems and currently work as a Police Officer.  According to my Cardiologist the valve opens fine but allows for some leakage of blood back into the left ventricle.  I have no symptoms and as of a July EKG and ECO my heart was functioning normaly.  My Cardiologist at the time told me that I may contiue to run but had to cut back of my heavy weight lifting in the gym, which I have.  He also stated that he wanted to see me yearly for a check-up inthe office and Bi-yearly for an ECO  Since then, I have done alot of online research and have found that even pushups and situps may not be a good idea. Along with this I just changed my PCP and at my physical with him he freaked on me saying that I was overly musculer and should stop lifiting weights, period!  My question is with the conflicting advice from my new PCP and Cardiologist who do I follow.  I'm thinking about dumping my PCP.  Any thoughts out there?  Thanks in advance!

[Momto3]

Although I'm sure your PCP is a good doctor, I think I'd stick with the cardiologist for more definitive answers.  Maybe you could give your cardio's office and call and pass it by them (the comment by the PCP)??

[CBC0912]

Went in to see the Heart Surgeon on the 12th. I wasn't given any leakage figures (1-4). He seemed to see more than the cardiologist at my HMO that did the angiogram. The cardiologist more or less shrugged off as minor the blockage. The Surgeon told me he would do a bypass, and replace the valve.  I guess I should have taken notes but  didn't. Last December I had a ECHO and the only one that mentioned anything was  the tech. Asked if I  was taking meds for my heart. I think someone knew what was going on but  didn't say so. As I recall now I was having dizziness from my hearing loss and I went  in on a Sunday on Urgent Care. The Dr. said he wanted to see if I had any leakage and not getting adaquit oxygen.  Its only  on going back and  thinking on this that its getting  clearer in my mind. So there was an EKG, Chest Xray, ECHO and Blood work. I don't know weither or not it would have helped me or not knowing at that time.

Now I'm getting hot thinking about what happened.
Later Charles

[Momto3]

It might be helpful if you requested a copy of your records (including the echo tape).  That way, you might be better able to understand what is going on.  I would also consider a second opinion, especially since the doctor is talking about surgery.  

Did you feel like you could speak frankly with the surgeon?  It might really help if you made a list of questions and asked for a followup appointment.  Try not to let this upset you.  Instead, become proactive and think about getting some more answers.  It may give you greater peace of mind if you understand just what is going on.

Where (city) would you have the surgery?  Are you near Cleveland Clinic or Mayo for a second opinion.  They are said to be the best at valve repair so it could be worth looking into.  I know the CC will do an "e consult."  If you go to their website, there is a link about how to go about getting a second opinion based on their interpretation of your records.

Best wishes!  Please keep us posted.

Connie

[patfitz1217]

My wife just got a call from her Dr. and her coumdin is up to 6.9. she suffers from very bad anxiety. She is overweitgh by at last 30 lbs and has constant headaches.  She smokes like a chimmy and is always short of breath.  what should she do?

[Momto3]

Hello and welcome!

If you are trying to direct your questions to the doctor, scroll up and click on the link for "Ask a Doctor."  The doctor answers two questions per day and does not generally answer a question within another post.

I'm sorry to hear your wife is not feeling well.  I'm sure she's heard this a million times, but if she can quit smoking, that would be great.  Is she able to walk or get around relatively easily.  If her doctor approves, maybe she could get on some type of walking routine.  

Does she have migraines?  If so, there are a lot of new medications and maybe her doctor can help her find one that works for her.

My dad's coumadin just went outta whack too....Just have to keep working with the doctor until she gets the right balance.  It's very nice of you to join the forum to try to help your wife : )

Enjoy the day!

Connie

[tamj]

Hi

I was diagnosed with mvp about in 1983. Ever since then I was told I couldnt get any dentalwork done without taking antibiotics..Well that changed today. I have been told that its not necessary anymore. Is that true???Now I am really confused.

Tam/47/female/residing in the us/from germany

[Momto3]

I have also been taking antibiotics for about 25 years.  I have mvp/mr and my cardio just told me "NO more antibiotics!"  I am so happy since the meds sometimes upset my stomache.  Just be sure your doctor says it's OK to stop taking them as a pre-med.

If you go to the website for the American College of Cardiology, you should be able to find the new guidelines.  I believe they were updated late 2006, or early 2007.

Connie

[redly414]

Hello everyone. After suffering my entire life with MVP and PVC's (which has gotten worse) I did a google search and came upon this forum, and I am so glad I did.

I'm a 38 year old male that was told in my teenage years that I had MVP and would need a valve replacement by the time I turned 30. I have not had that surgery. My visits to the doctor offices have been spotty at best, even though I've had to have ER visits every couple of years with severe arrythmias. On my best days my PVC's are limited to probably 500 a day (that I notice at least), and on the worst days, 1 every 20 seconds or so. Since every person and doctor has told me it is benign, I've tried my BEST to put on a happy face and "ignore" them, but they so hamper my quality of life. I'm terribly depressed all the time (I've been on every anti-depressant known to man but no chemical is going to change the structure of my heart), and the non-stop adreneline rush I get after every PVC (especially the "big" ones), really wears me down daily. I have had extremely limited health insurance (government supplied) so the doctors are never really enthused about running tests and usually brush me off. I am seeing a doctor this friday however and am going to be a little more aggressive than I usually am.

The reason I went searching for these forums, however, is that in the last week or so I've had a string of those "bad" days, which has never really happened in my life before, and I'm a bit concerned about it. I've had holer monitors, ekg's, echocardiograms done, but any results would be at least 5 years old. I recal my doctor saying something about a "wave" being a bit abnormal and that I did have more PVC's than the normal person, but other that, just said to "deal with it". Do my current symptoms warrant getting these re-done, do you think?

I am thoroughly conviced my anxiety and stress is the main cause of my increase in symptoms. The other day I was having PVC's just about every other heartbeat...after 6 hours straight of this I finally called an online nurse to talk about it. She of course, urged me to go to the ER..but having gone through that before I wasn't inclined to do so. What always happens, apparently with a lot of people here, is that as soon as you get to the ER the PVC's nearly stop. Well guess what, as soon as I got off the phone with the nurse, they stopped. Period. After resting for an hour I even walked to the park and relaxed and spent the entire rest of the day almost PVC-free (at least ones I could feel).

Anyway, sorry to go on and on, but would like some advice about this.

I take 25mg of Metoprolol (beta blocker) twice daily for the palpitations and high blood pressure. I also take 1 mg of klonopin as needed for anxiety. I've been thinking of asking the doctor to increase the beta-blocker dosage. My blood pressure certainly isn't in danger of being too low.

Jason

[becstewart]

I'm a mother of a 7 year old who was just diagnosed with 2 leaky heart valves one on right and one on left her cardologists said to give it time it might heal.What will happen if it doesnt? They are really no to concern with the one on the right but hes goin to keep a check on the one on the left.I'm scared out of my mind but let her see it.