PVC? Mitro? Lungs?

Hi,
I am 29 year old female, in good health but about 50 pounds overweight.  In January of this year I all of the sudden had this gripping feeling over my heart twice.  Then after that I started feeling palpitations.  EKG's have all came back normal.  Echo was normal except I have a slightly enlarged Rt. Ventricle.  Measured 3.0. I was put on a loop monitor and was diagnosed with PVC's.  I was sent back this month for a follow up Echo and that was measured at 2.9 and they found minimal mitro valve leakage.  Now they want me to go in to see a lung specialist for the enlarged ventricle. They are questioning if it could be back pressure from my lung.  The CT scan they did back in January was normal.  I was checked for Sleep Apneia and nothing showed up. I'm confused on a lot of things here.

1 - Could I be feeling the mitral valve leakage instead of PVC's?

2 - How come they didn't see the mitral valve leakage on the first Echo?  How dangerous is it and should I be worried about it?

3 - What could this lung pressure be? I have to wait a month to see the lung specialist and just want to have some sort of idea what I am dealing with.

I am in the process of trying to get pregnant and would like any sort of reasurrance that I can go ahead with that plan.  

Thank you so much for you time and help.

[CCF-M.D.-MJM]

Hello,


1 - Could I be feeling the mitral valve leakage instead of PVC's?

Minimal mitral leakage would not cause any symptoms.  If it did cause symptoms, the symptoms should be present most of the time, not rarely.  If the symptoms correlated with PVCs on monitor, that would clinch the diagnosis.

2 - How come they didn't see the mitral valve leakage on the first Echo? How dangerous is it and should I be worried about it?

I would not give mininal MR a second thought.


3 - What could this lung pressure be? I have to wait a month to see the lung specialist and just want to have some sort of idea what I am dealing with.

Typically they would give a number for "right ventricular systolic pressure" or RVSP.  This would represent pulmonary pressures and give an idea if these pressures are high.

The differently diagnosis of pulmonary hypertension is fairly broad and requires several studies like sleep studies, blood work, chest xrays, maybe a chest CT or VQ scan looking for blood clots.  You have had several of these studies and they are all normal.  You will need to see a specialist to see how likely it is that there is problem and how they want to work it up. Unfortunately, the differential diagnosis is probably 100 items long.  Sorry I can't be more helpful.

Good luck and thanks for posting.