MVP a process?

[jan]

Dear Dr.,

I would like to know why they call MVP a "process". If it is actually a "process" it definitely is slow or very limited. It seems like most won't go on needing any intervention. My cardio's colleague put me on antibiotics since it is "a process". He said you never know when the time for the antibiotics has arrived, maybe between echos. That is really curious to me. Now, I am stuck on antibiotics for dental visits, not a big deal but... He said he isn't a "purist". (He did the last echo,a reg., while I was in the hospital).

Also, the TEE (just a few months before the above mentioned echo), just showed mild "buckling" of the anterior leaflet, which my cardio says isn't MVP. It did show the mild MR and TR. All the reg echos diag. MVP, I had at least 4. One even said myxomatous. It is only the anterior leaflet (1st echo said thicken'g). Since most people are diag that way could it mean that many don't have MVP?

1)What are your thoughts about the MVP "process"? Is it actually a "process" and what is that process? Sounds stupid, but I find it confusing with the info given. 2)What about "purist"? How do you feel about that? 3)Do I have MVP?

Thank you for your time.

[CCF-M.D.-RCJ]

Jan,

Thanks for the post.

Q1:"I would like to know why they call MVP a "process"."

Who is they?  I have never heard MVP called a process, nor do I think of it as a process.  MVP stands for Mitral Valve Prolapse.  Is it possible that you misunderstood the pronunciation of "prolapse" for "process"?  Otherwise, I cannot explain why someone would call MVP a "process".

Q2:"What about "purist"? How do you feel about that?"

I don't know what he/she is talking about.  And when I don't understand something, it tends to make me angry, so I guess I feel angry about that.

Q3:"Do I have MVP?"

Yes.

I mean No.

Uh, maybe.

I simply can't tell without seeing your echo.  You wouldn't buy a car based on someone's description of it on the internet; likewise, I'm not buying that you have MVP based on discrepant echos.

I can tell you the diagnosis of MVP is way, way over-used.  Have your echo(s) read at a large valve center, like here or Mayo, for a better answer.

Good luck.

[jan]

I didn't misunderstand prolapse and process.  It isn't the first time I heard that is was a process, I've also seen it on the internet.  I may be mistaken, but I believe it has even been stated as such on this forum.  It was said suggesting the it progresses.  I guess as my mother's did, hers to the point of needing a replacement.

All my echos were in the past few years.  All of the transthoracic said MVP, the TEE the cardio told me just showed buckling.  All involving the anterior leaflet.

As far as purist, as far as my understanding he didn't go strictly by the guidelines. ?

I had ST-T wave chgs on ekg's too, I am told that can be MVP or after tachy.  Who knows? *rolls eyes*

I do have dysautonomia, two of the diag are IST and NCS, but I do not have what many call MVPS.

[CCF-M.D.-RCJ]

Thanks for the clarification.  I understand now.

It is fair to say that the leakage (called regurgitation) sometimes associated with MVP will often progress.  This is akin to a leaky tub-stopper.  Once the stopper starts to degenerate and leak, it will often continue to degenerate more, and thus leak more.  The leakage sometimes associated with MVP will also sometimes worsen, but not always.

As to whether or not you actually have MVP, it is unusual that the TEE would not have been definitive.  I would still consider having a formal review of your echos.

Best of luck.

[jan]

Thank you!  I really didn't expect another response from you and I really appreciate it.

I'm embarrassed, because I don't understand your analogy.  
Are you saying that either/or/ or a combo of valve and regurg can worsen?  What would cause any of it to worsen?  I guess that is what I was asking when I asked what the process was.

I have only mild regurg. and if I have MVP, that is only mild, too.

I hope I am not pushing it asking you to further clarify.  If I am, I apologize.

Thank you.

[CCF-M.D.-RCJ]

Hank hit the nail on the head.  I'm not sure that I can add much at all.

You asked which was it that "worsens".  The bottom line is that if the valve degenerates further, because MVP valves are fundamentally weaker, then the leakage will worsen.  But not all MVP valves are so "weak" that they necesssarily worsen.

[jan]

Thank you, Dr. and hank!

[jan]

Hankstar, I hope you can answer a few of my questions.  I don't want to presume on the dr. again and you seem willing to help and read up on these matters.

I went back and read that analogy and I understood it. Funny how a little brain damage can interfere with comprehension and just time to time.  *blushes*  Actually, it's incredibly frustrating.  The brain lesion is why I had the TEE, because they were ruling out stroke.  TMI?

I was wondering if you knew if:

the valve can weaken without myxomatous chgs?

if "thickening" is actually an ongoing process (there's that word again lol), but it has that connotation.  Does it have anything to do with myxomatous chgs?

if "jet" is just another way of saying regurg or if there is some specific meaning to it?  If there is some specific meaning then what's the diff...?

I am not worried about the MVP, believe it or not.  It was just my cardio's colleague telling my dentist I needed antibiotics after my cardio took me off them following the TEE, that made me start asking questions.  It is just curiosity and I have a few more lives left, so...  :oP  As a matter of fact the only reason my cardio looked for MVP was due to the NCS.  

I am curious too, if my mother needed her mitral valve replacement and/or the bypasses due to having diabetes?

Just a rabbit trail...  They say I have mildly elevated pulmonary pressure and I know that is based on the TR, but have read that TR is often due to MR.  What have you found on this (if anything)?

Wow, that's alot of questions!  I will send a check to your email Tuesday, for your help today.  ;o)  Thanks for your input.

[jan]

Thank you for your help.  Sounds like you are as lost as I am on those questions though. LOL

One cardio had put myxomatous appearing valve on the echo he read.  My cardio was relieved he didn't find that when doing the TEE.

Fortunately, I am really not worried about progressing just because my mother did.  If there is anything I should be concerned with it is prob her heart disease (having had the 2 bypasses, she req. another later but was in CHF).  I believe that her diabetes may have attributed to the matter, but am not sure since she was diag. with that later.

MS has been mentioned to me and with that my primaries suggested that the IST and NCS might be related.

Thanks, again.