Progression of MVP

[dande4]

Hello Dr.,

Thank you in advance and Happy New Year! I am a 37yr old F.I was diagnosed 13 years ago with Mitral Valve Prolapse with trace regurgitation. No meds except tenormin 12.5 and as needed for hyper/beta-adrengic symptoms. Since then have been monitored routinely by the same Cardiologist. Have had 3 uneventful pregnancies and have echos every 2 years, stress echos. My last echo showed the same, mvp not seen in all views, suggestive of MVP but not meeting strict criteria of MVP. Stress portion showed no abnormalities, normal readings etc. Color doppler revealed Mitral regurgitation.  On previous echos, which I have copies of, the doppler showed trivial mitral regurgitation. These reports are identical in every way every time, it seems to be a standard format they use and the technician changes certain items if necessary. I questioned my Dr. on my results, he said everything was the same, no change that I was doing very well. I questioned if the regurgitation was worse since it went from trivial to just saying mitral regurgitation. He said all remained the same. Unfortunately at times I dwell on the specific wording and worry that it has changed somewhat. I asked if I rated on a scale for the murmur and he said no.

I am sure I am torturing myself by obsessing on this at times, but that is my nature, somewhat, and need reassurance at times.

Does this slight wording make any difference, is it just the individual technicians interpretation? I know I need to get past this. I thank you for your time and have a healthy New Year!

[Buck40]

I was diagnosed with MVP about 15 yrs ago. The Mayo Clinic
has a set of 10-12 grades of MVP. Mine was a 2, as I remember,
two from the least prolapsed side. At the time I was having mild
chest pain which was not worsened by exercise, and not helped
with Nitroglycerin.
    We who have MVP (and those with joint implants) have about a 1 in 200,000 chance of dying from an infection (endocarditis, I believe) if we fail to take our 4 Amoxicillin (or Clindamycin if allergic to penicillin) an hr.before our dental visits. That's not much of a chance of dying, but I don't want to be the one;
and my Dentist's insurance co. sure doesn't want me to die either!
     I've been on a beta-blocker ever since. I've had little or no problems from it. At age 63, I still walk 2 miles, 3 times a week
Buck40

[nitro6062]

A related discussion, Mitral and aortic regurgitation was started.

[[email protected]]

I am a 24 year old female and I have recently had an echo to investigate a heart murmur I've had for years. I occasionally get palpitations with a fast heart rate of between 120 and 160 per minute. My echo, I was told showed a structually normal heart, but mentioned elements of trace mitral, tricuspid and pulmonic regurgitation. However, all valves are normal. I was quite satisfied with this result and being that trace regurgitation was all that was mentioned I took this to be perhaps a normal finding, especially as shown in 3 valves. However, I took the report to my dentist and they are now refusing to see me until they get a written statement from my cardiologist informing them of whether I need anti-biotic cover. I am somewhat confused, as I don't have any valvular prolapse, so wouldn't have thought my risk of endocarditis was any higher than the general population. Has anyone been told a similar thing? I am an NHS patient so it can take months for written statements to come from hospitals and it is very difficult to get an appointment with the cardiologist to ask my question. In the meantime I am more worried about my teeth than my heart as I have very inflammed gums and a peridontal pocket that needs regular review. Is trace regurgitation a normal finding on echo???? Please help  

[elhaal]

Everything seems very confusing with the MVP and the diagnosis the MDs' provide.  

I would like to write in and ask some questions and how do I do that?

I am very confused about my own test results and the so called trace MR and TR and what that would mean and if anything at all will come from that.

Personally I am trying to get an insurance and that seems to be just impossible.  I am 63 years old, and see myself as healthy!

I think we need to be better informed and the MDs' would need to take more time with us and explain situations more accurate.

My e-mail is:  ***@**** - I really like to write in and get a second opinion.

Eira Gregard

[jan]

I would like to know why they call it a "process" or "benign process".  It seems like most won't go on needing any intervention.  If it is actually a "process", it definitely is slow or very limited, so I am curious why my cardio's colleague put me on antibiotics since it is a "process". He also 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.  He said he isn't a "purist".

Also, the TEE just showed mild "buckling" which my cardio says isn't mvp, all the reg echos diag. mvp and since most are diag that way...  It is only the anterior leaflet and there is mild regurg and mild TR.

Has anybody else had such confusion with different interpretations and diff recommendations?  Well, I guess everybody.  What are your thoughts about the mvp "process"?  What about "purist"?

Thanks.

[dande4]

I get confused by their terminology. I don't show a true MVP on the echo but on a certain view it is suggestive of MVP. Go figure. I was told trace mr and trace tr many years ago. Other times echo showed no tr. Last report just stated mr and tr. Did not say trace, mild or anything. Dr. said everything was the same. He has told me that I don't really need the antibiotics but take it anyway for dental visits. Confusing at times they way the express themselves from time to time, from Dr. to Dr. and report to report....

I've also been told MVP is a benign process, the MVP with a structurally normal heart. He has said their is another MVP which has specific changes to the heart. After all these years, I'm still confused..lol :}

[lcampgirl1]

i too have mvp and my blood pressure has been going up lately. i am under a drs. care for high colesterol but have been told that mvp will make you feel scared about dying all the time.  i have been having some chest neck and arm pains lately but am afraid my dr. will think that i am just excited.  can mvp cause you to have these pains

[DottyCece]

I agree with the Doctor.  I had mitral valve prolapse for 14 years and had periodic ECHOs and was told things were the same etc. So, my cardiologist left the clinic I go to and I never was assigned to another one.  Then suddenly last Jan developed rapid uncontrolled atrial fib and had sever regurgitation in both the Mitral and Tricuspid valves..ended up having a mitral valve replacement and numerous complications and problems...so keep your appointments, see the cardiologist each year and you will be fine.  My mistake was to not be be assertive and see another cardiologist and follow up.  My primary physician was never concerned though I had a 3+ systolic murmur...I feel the victim of a lot of things some of my own doing however.

[Cleveland Clinic]

dande,

The technicians do not interpret the echocardiogram, the physicians do. There is nothing in the wording that alarms me, I would trust your cardiologist. It sounds like he is giving you very good care.