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Severe mitral regurgitation
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Severe mitral regurgitation

Dear Dr.

What are the symptoms of severe MR? Is it posible to not have any symptoms with severe MR?
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Avatar_n_tn
Dear Erik,
Symptoms of mitral regurgitation include shortness of breath, fatigue, atrial fibrillation, swelling in the legs, and non-specific complaints.  It is possible to have severe MR and not have noticable symptoms.
10 Comments
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Avatar_n_tn
Erik, It seems like you have gotten some additional information  from your cardio doc after your last posting.When I developed severe mitral regurgitation it was not initially diagnoised. I t was only after I complained that I had severe fatigue unrelieved by rest and shortness of breath was a TEE done that showed backflow into the pulmonary artery.Additionally, I was having cardiac arrythmias and increased blood pressure, all brought on by an increased work load for my heart.With all the other symptoms you had posted on this forum (atrial fib and possible TIA) it seems that you may not be believing that things had progressed. No lecture but as my comments from before....find a doctor you can trust and have the EP study, TEE and a cardiac surgical consult.This is a problem that is fixable or at least manageable.
It all can seem overwhelming to have cardiac problems at a young age but, there are some very good specialists who can get you feeling better. Good luck
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Avatar_n_tn
Debra-

Actually I have no symptoms. I have only mild (1+) Mitral regurgitation. I had only one  four-hour episode of A-Fib and have been asymptomatic since. I had just drank two glasses of red wine before the episode. My Magnesium levels were very low also which my doctor told me can cause A-Fib. I am on Cardizem and Magnesium supplements and am doing fine. I have no shortness of breath at rest or with exercise. The reason I am asking what the symptoms are for severe MR is because the Cardiologist who answered my question on this forum before said I might have severe MR causing my A-Fib. I disagree. If I had severe MR, I would be having other symptoms, including more episodes of A-Fib. I have what is called Lone A-Fib. Thanks again for your comment!

Erik
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Avatar_n_tn
Didn't mean to lecture, I agree with the cardiologist on the forum, atrial fib usually goes hand in hand when someone has mitral valve disease.One run of four hour interval of atrial fib can certainly be scarey.I am not trying to scare you, and I am not a cardiologist only a nurse who has lived with cardiac disease and its complications.I had only occassional atrial fib with my mitral valve disease.It did not clear after surgery.The cardiologist I was seeing post op  blew it off because of my young age .I had a massive stroke from atrial fib two years post op.It has taken me two long laborous years to recover moderate motor function.I would definitely see an electrophysiologist and have an evaluation done.The A-FIB may only be a fluke but it is worth investigating.The problem with A-fib is not while it is occurring ,it is when the heart returns to normal sinus.
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Avatar_n_tn
eric, i would have to somewhat agree with debra on the a-fib and mitral regurgitation.  often, the a-fib is a precursor of more serious mitral problems.  the longer you are in a-fib or the more frequently you go into a-fib, the higher chance of staying in a-fib, even after surgery. your heart is working harder when you have regurgitation, which causes higher blood pressure.  i went into uncontrollable a-fib even with meds.  had emergency surgery to repair mitral valve. 5 years later had surgery to replace mitral valve and tricuspid valve.  i am still in a-fib 6 and 1/2 years later.  i am on coumadin because i have mechanical valve, but would also need to be on it because of a-fib.  i know you can still have stroke on coumadin (i guess that happened to debra), but chances are reduced.  i am also on aspirin therapy.
i would get things checked out with echo and/or TEE to make sure things have not progressed to a more severe point.  i had symptoms before surgery, but not major.  i had compensated so much for my fatigue and shortness of breath.  it was normal for me to feel that way.  good luck and keep us posted.
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Avatar_n_tn
It is possible to have severe mitral regurgitation without symptoms.  I had no symptoms and even passed a stress test yet I had severe mitral regurgitation which required surgery to fix.  It is dangerous to rely only on symptoms because by the time you notice them, sometimes permanent damage has been done.
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Avatar_n_tn
TL this comment is really for you as well.I couldn't agree with you more.The damage caused by the regurgitation is often the difference between an elective repair and an emergency repair and the ability to repair versus replace.I am not sure what Erik is looking for .There is no one answer.It depends on the skill of your cardiologist, the electrophysilogist and cardiac surgical opinions. An entir team of cardiac specialists should be conferingbecause of Erik's symptoms and obvious concerns and what appear to be unanswered questions.
My mitral regurgitation went from mild to severe in less than 3 months. My internist said he never saw heart valve disease progress so suddenly and result in emergency procedures for heart failure.
Erik, get some opinions from a good cardiac team at a major teaching hospital.
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Avatar_n_tn
Just to add a bit more to the other comments....I had moderate to severe mitral regurg for several years with no symtoms (symptoms) at all.  I had an echo in 12/98 that showed some slight expansion of my heart chambers, but still no symptoms.  I did a week of aggressive scuba diving down to 130' depths in 2/99...felt absolutely fine.  A follow up echo in 3/99 showed my left atrium and ventricle had dilated significantly...still no symptoms.  I went in for mitral repair 5/99 and, except for the onset of PVC's, never experienced any symptoms at all.  I was told the best approach is to have the mitral valve repaired or replaced before the onset of symptoms.
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Avatar_n_tn
Can anyone tell me what is considered severe mitral regurgitation?  2+?  I just received an echo report that indicated 2+ mitral regurgitation, where 6 months ago I only showed a trace.  Also, the recent echo indicated a slightly enlarged right atrium, and 20% enlargement in the left ventricle and left atrium.  Left ventricle and atrium are still within normal limits.  Docs seem to think this is all fine, but I'm a little concerned as I also have slightly enlarged liver, inferior vena cava, and haven't been feeling well - tired all the time.  Thanks for any comments.

Ch
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Avatar_n_tn
2+ Mitral Regurgitation is mild to moderate, 3+ is moderate to severe and 4+ is severe. A TEE (Trans Esophageal Echocardiogram) will give a more accurate diagnosis of your Mitral Regurgitation.


































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