Mitral Valve and Tricuspid Valve Regurgitation

[wrpatton]

I have had 2 echos that showed mild Mitral and Tricuspid valve regurgitation.  My cardiologist said they are not significant and that we will continue to check it every couple of years. I have had swelling in my legs for the past 4 years and they have not been able to find a cause.  I have recently noticed swelling in my abdomen and I have had to increase the dose of my diruretics because the swelling in my legs is getting worse.  My primary care physican is concerned, but my cardiologist is not.  Do I need to be concerned?

[kenkeith]

Mild mitral and tricuspid valve regurgitation is considered medically insignificnt.  That would not cause swelling of peripherals and abdomen.

Edema occurs when tiny blood vessels in your body (capillaries) leak fluid. This leakage can result from damage to or increased pressure in the capillaries. When your body senses the capillaries are leaking, your kidneys begin to retain more sodium and water than normal to compensate for the lost fluid from your blood vessels. This increases the amount of fluid circulating through your body, which causes the capillaries to leak more. The fluid from the capillaries leaks into the surrounding tissue, causing the tissue to swell.

Edema can be a side effect of some medications, including:

Drugs that open blood vessels (vasodilators)
Calcium channel blockers (calcium antagonists)
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Estrogens
Certain diabetes medications called thiazolidinediones
In some cases, however, edema may be a sign of a more serious underlying medical condition. Diseases and conditions that may cause edema include:

Congestive heart failure. When one or both of your heart's lower chambers loses its ability to pump blood effectively — as happens in congestive heart failure — the blood can back up in your legs, ankles and feet, causing edema. Based on the info posted this can be ruled out.

More likely the problem is due to the following:

Cirrhosis. This disease causes scarring of your liver, which interferes with liver function, causing changes in the hormones and chemicals that regulate fluids in your body, as well as increasing pressure within the large blood vessel (portal vein) that carries blood from your intestine, spleen and pancreas into your liver. These problems can result in fluid accumulating in your legs and your abdominal cavity.

Kidney disease. When you have kidney disease, your kidneys may not be able to eliminate enough fluid and sodium from your blood. The extra fluid and sodium increases pressure in your blood vessels, causing edema. Edema associated with kidney disease usually occurs in your legs and around your eyes.

Kidney damage. Damage to the tiny blood vessels in your kidneys (glomeruli) that filter waste and excess water from your blood can result in nephrotic syndrome. One result of nephrotic syndrome is low levels of protein (albumin) in your blood, which can lead to fluid accumulation and edema.

Worst case scenarios.

[wrpatton]

Thank you for the info.  I know that it is not related to any medication that I am taking as Lasix and potassium are all that I am taking.

My liver function and kidney function tests all came back normal.  Is it possible for these test to come back normal but that still be a possible problem?

Thanks again.

[kenkeith]

Yes, there can be a false negative with almost any test. For lab tests it is necessary to prepare prior to the test...fasting, etc. And certain medications can affect the accuracy of some lab tests. For example, taking Tylenol or Naproxen Sodium or 500 mg or more of Vitamin C before a cholesterol test can affect the accuracy of the results.

Generally speaking, one should not take any OTC pain medications, smoke tobacco or marijuana, or exercise vigorously before lab tests. Some antibiotics can also interfere with some tests.