Tricuspid Valve Regurgitation

[Alex__0]

Posted by Alex on May 06, 1999 at 21:20:45
Hello:
I am a 20-year old male, non-smoker, currently a junior in college.  Last December, I started experiencing chest pains and discomfort, mostly on the sides of the rib cage.  The pain, however, was not concentrated to one area as it constantly changed locations on the chest.  The doctor wasn't able to hear anything through the sthetoscope and attribut>
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t be on a regimen of Advil.  The pain is rather dull and comes and goes throughout the day.  It does not wake me up during my sleep.  The pain disppeared within days.  Two weeks ago, the pains were back.  A different doctor at the school clinic listened to my heart and lungs and couldn't make a diagnostic.  He also attributed the pains to chest wall inflammation and put me on Advil.  However, he did hear a "significant" heart murmur (first time it was heard by any doctor).  He said that the murmur was most likely not benign, possibly aortic in nature.
He recommended I see a cardiologist.  BTW, my mom did have her mitral valve replaced.  Yesterday, I went home to see a cardiologist.  He did an EKG, Echocardiogram, and Stress Test (13 min.).
He said that my heart structure was fine but diagnosed "Mild to Moderate" tricuspid valve regurgitation or leakage.  The echo report were the following:
-nl RV + LUSF
-nl heart size and wall thickness
-nl regional wall motion
-nl structure/AV MV TV + PV
-no MVP
-No pericardial infusion
-mild to moderate TR
There were a whole bunch of measurements numbers which all fell within "adult values".  The stress test report mentioned:
-maximal exercise stress test
-no chest pains
-no hemodynamics
-no ischemic EKG
-good exercise effort
-this is a normal exercise stress test.

He told me that the leakage was slightly above inviduals my age but gave me the impression not to worry about it.  He gave me no exercise restrictions and no medication.  He also told me to come back in a year for another follow up echo.  He concluded that my chest pains were not due to the heart but were most likely skeletal/muscular in nature and to take ibufrofen.  My questions are:
-What are the long term effects of mild to moderate regurgitation?  Will surgery be required in the future?  Is there any medication to cure such
disease?
-Does it get worse?  Does it get better?
-What could cause the chest pains?  Stress?
Thanks for your help!  And sorry for the long message.

Posted by Alex on May 06, 1999 at 21:31:47
I forgot to mention that the cardiologist could not hear the murmur, in contradiction to what the school doctor said.
Alex

Posted by CCF CARDIO MD - MTR on May 07, 1999 at 08:40:12
Dear Alex, since the cardiologist could not hear a murmur, I think that provides more evidence that this is a benign problem.  Good luck!

Posted by Alex on May 08, 1999 at 04:03:53
Hello again:
Thanks for your prompt reply.  I have two more questions:  
-Does the fact that my mom had her mitral valve replaced (due to Rheumatic Fever, according to my dad) increase the chances that I will need mine replaced?  Is valve disease hereditary?  If it is, why is my mom's problematic valve (mitral) is different than mine (tricuspid)?
-What would be physical warning signs that the regurgitation is getting worse?
Thanks again for you help.
Alex

Posted by CCF CARDIO MD - MTR on May 10, 1999 at 11:33:46
Dear Alex, if your mother had Rheumatic Fever as the cause of her mitral valve disease, there is no association with your suspected valvular disease unless you had a documented episode of Rheumatic Fever.  Again, I want to stress that I do not think you have any valvular problems and that your heart is indeed normal. Therefore, I don't think you should worry about your long-term prognosis nor what type of symptoms you should be on the lookout for.  My best advice to you is to enjoy life and not worry about your heart.