Mitral Valve Regurgitation

In 2002 I had an echo cardiogram that diagnosed me with Mitral Valve Prolapse with some regurgitation  I recently obtained the medical report and it stated that I has prolapse of the anterior leaflet, thickened leaflets, and 2-3/4+ posteriorly directed regurgitation.  Aortic valve had mild regurgitation with right cusp appearing larger than other cusps.  Tricuspid valve had trivial regurgitation.  All the other things appeared normal.  Last year in 2008 I requested another echo cardiogram, it said that left ventricular size and wall thickness was normal with an EF of 77%.  There was mild to moderate or mitral valve leaflets and chordal apparatus was noted as well as mild to moderate mitral valve prolapse.  No stenosis was seen.  Mild to moderate regurgitation was seen.  Mild tricuspid regurgitation was seen.  I also have trouble exercising for very long and get dizzy when I stand up fast, But other than that I don't seem to have alot of recognizable symptoms.
Besides antibiotics, I haven't been told that any thing is abnormal, but then again I'm dealing with military doctors that tell me these things.  What I need to know is if the 77% EF and the regurgitation is something I should be more concerned with.  Any advise would be appreciated, thanks.

Figures on report:
Left ventricular:
LVDD 48 cm
LVSD 26 cm
IVS    11 cm
PW      9 cm

LV Function:
Estimated EF 77%
Cardiac output 3.2 L/min

Left Atrium:
Diameter 35 cm
Volume 16 cm^2

Right atrium:
Volume 14 cm^2

Aortic valve:
Aortic root diameter 28

Tricuspid valve:
peak reg velocity 215 cm/sec
RVSP 28 mmHg

[ed34]

Basically the volume of blood in a ventricle is calculated when the heart is relaxed. Then the volume of blood remaining in the ventricle after it has 'squeezed' is calculated. This then allows us to determine the volume of blood that has been pumped out of the chamber. We can work out a percentage of the total blood ejected from the heart from these numbers and that is your ejection factor.
The volume in a ventricle chamber when it is relaxed(before squeezing) is the end diastolic volume EDV.
The volume in a ventricle after contraction is the end systolic volume ESV.
The difference between the two is obviously how much blood volume has been pushed out of the heart, the Stroke volume (SV).
Ejection Fraction is the SV divided by the EDV.
E.G.  A man has 70ml stroke volume (SV) - blood pushed out of chamber
         end diastolic volume 120ml (EDV) - blood in relaxed chamber (full)
         70ml/120ml = 0.58 = 58% EF
LVEF - left ventricle  RVEF - right ventricle

Normal values are - 50/55 - 75%

Anything above 75% is classed as abnormal and can be a result from heart tissue damage or inefficient Mitral valve. Above 75% the blood is too forceful when leaving the heart and can cause high blood pressure. There have been people with LVEF of 90%
and above.

I hope this helps you.

[ssgtguy]

I thought an EF of 77% was a little high for someone of 36yrs old.  I thought the regurgitation had the possibility of causing me problems later.  I will be separating from the Air Force in several months and will need to see doctors to determine if I'll be eligible for disability.  I think I'll need a stress test.  Should I be happy if they award me a 0% or should I push for higher.  Regardless, hopefully they'll refer me to a good cardiologist that will provide me with a thorough diagnosis.

[ed34]

Before you push for disability, get reports from good cardiologists. In the forces they may try to make your condition appear less problemtatic to keep costs down.

[kenkeith]

An LVEF over 75% is considered too high, and medically-termed as being a hyperdynamic or a hypercontractile left ventricle , that is, the heart is pumping forcefully/forcibly, an excessive amount of blood is being pumped out.

According to various medical literature, there a few specific clinically-recognized causes of a hyperdynamic/hypercontractile left ventricle, which includes aortic valve regurgitation (leakage),sometimes the mitral valve, some congenital heart defects (e.g.,  septal defect), and hypertrophic cardiomyopathy (HCM). The condition may/can also be deemed as idiopathic (no known cause).

Did the doctor or report mention LV hyperdynamic systolic contractility? ...usually if there was any underlying issue to cause that, they would mention it in the report......it can cause symptoms depending on the underlying cause. It can also be a normal variant in young individuals and athletes.  Ask your cardiologist for some explanation for the forceful contractility of your left ventricle.

I have moderate MVR, and that does limit my exercise tolerance due to shortness of breath.