Mitral valve prolapse with moderate regurgitation

[SG1967]

I am 42, female and have just been diagnosed with "Bi-leaflet MVP; at least mod MR, hyperdynamic LV".  The Eco Cardiogram report was as follows:

Sinus rythum
LV is mildly dilated with hyperdynamic LV systolic function
Mitral valve opens well.  Mitral forward flow is raised 1.6m/sec.
There appears to be a degree of prolapse of both mitral leaflets with associated eccentric jets of MR which appear at least moderate in degree when combined.
LA appears normal in size.
Aortic valve is tri-leaflet and opens well with normal outflow velocity.  Trivial AR.
Normal right heart with normal RV systolic function (TAPSE=31mm)
Trivial TR; estimated PA systolic pressure is 19mmHG + RAP
IVC = 22mm with respiratory collapse < 50% (RAP = 10-15mmHg)
Normal aortic root.  Normal aortic arch.

I am currently waiting for an appointment to see the cardiologist to discuss the results.  Whilst I understand the basics of this means in terms of what my heart is doing what I want to know is what are the practical implications of all this and would be very grateful for any information and advice.

[kenkeith]

QUOTE: "LV is mildly dilated with hyperdynamic LV systolic function."

>>>>Normal ejection fraction of the left ventricle is 55 to 75% meaning the amount of blood pumped with each heartbeat.  American Heart Association: "What’s too high?:  EF higher than 75 percent could indicate a heart condition like hypertrophic cardiomyopathy.

QUOTE:"Bi-leaflet MVP"

The one-way valve that separates the upper and lower heart chambers has some back flow of blood from the lower chamber to the upper chamber with each heartbeat.  The cause is the leaflets do not close the orifice adequately, but billows back into the upper chamber with the pressure of the lower chamber when the heart conracts to pump blood.  MVP is not an uncommon condition, and usually does not progress nor cause a problem. At least moderate MVP may be problematic, and possibly a cause of hypertrophic LV, but LA (left atrium) is normal in size (MVR can enlarge the LA).

When the MVR presents a problem, it would reduce the amount of blood pumped into circulation with each heartbeat.  The left ventricle dilates to compensate for a low cardiac output of oxygenated blood into circulation and this dilation increases contractility of the heart's pumping chamber, thereby more blood pumped with each stroke.  

The dilation of the LV can be explained by the Frank/Starling principle law of physics. The fundamental principle of cardiac behavour which states that the force of contraction of the cardiac muscle is related to LV chamber diameter. The energy set free at each contraction is a simple function of cardiac filling. When the diastolic filling of the heart is increased or decreased with a given volume, the displacement of the heart increases or decreases with this volume. As an analogy for contractility force can be like stretching a handspring...when stretched it recoils with more force, but if over stretched the recoil can become limp (the heart begins to fail with weak contractions).

The dilation of the left ventricle is normally dynamic and helps regulate an even flow of blood between the right and left side just as heart rate and blood pressure.  But to over stretch creates hyperdynamic systole dysfunction.

No other problems noted. Normal pulmonary arterial pressures.

Thanks for sharing, and if you have any further questions feel free to post.  Take care.