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heart valve disease

Hi,
I have done echo 2 D test..and the report came with mild mitral valve prolapse with trivial mitral regurgitation,mild regurgitation in aoritic n triscupid valve with LVEF 60%..I am having breathing problem while doing little household work,even while eating I am facing the breathing problem with every bite of meal..sumtimes I feel chest pain.n become restless..My doctor has prescribed me Inderal 10mg with a sleeping pill of 0.5 two times a day..but says nothing to worry as i am fine...My question is if  I am perfectly fine then why the doctor has prescribed these tablets for more than three months..Please advice me what to do? as I am still having the breathing problem with fast heart pulse rate despite taking these medicines for more than one month..

Thanks in advance
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367994_tn?1304957193
Inderal is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins), and it is used to treat angina (chest pain), hypertension (high blood pressure), heart rhythm disorders. It is also used to treat or prevent heart attack.

Your chest pain and shortness of breath may be due to the respiratory system if medication for a heart disorder is not effective treatment for your symptoms.  
A pulmonary embolus (blood clot) is one of the life-threatening causes of chest pain and should always be considered when a patient presents to a healthcare provider with complaints of chest pain and shortness of breath.  There could be blood clots in the pulmonary vessel as well.
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I was admitted to ER just based on shortness of breath and fast heart rate (115) at rest so those symptoms should be taken for seriously..  The diagnoses was heart failure and an enlarged heart. Your mild valve condition would not be the underlying cause for your sympoms, and  EF (ejection fraction) is the fraction of blood pumped with each heartbeat and normal ( 55 to 75%) . There doesn't appear to be a heart problem.

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976897_tn?1379171202
For you Doctor to say not to worry you are fine make me question his professionalism. I would seriously complain to him/her and state you will change to a different Doctor if the enthusiasm doesn't change. An echo scan doesn't always pick up coronary artery problems in the heart, mine showed fantastic results yet it was known from an angiogram that they were in a real mess. I too suffered shortness of breath and fatigue, problems eating.
If I was in your shoes, I would ask to be given a CT angio and/or a nuclear scan. They really haven't discovered your underlying problems and need to get on the case. Through all my
ordeals I have had an EF of 70%.
You could always ask "If my heart is fine and there's nothing to worry about, why am I on a beta blocker". BB are used mainly to keep the heart muscle from over reacting to things like adrenaline, so why would you want to do this to a heart which has no problems I wonder. Blood pressure can be controlled in other ways.
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367994_tn?1304957193
I read where ischemia causes shortness of breath, but I'm not convinced just having ischemia causes shortness of breath that some writers seem to indicate.  If the ischmia is causing shortness of breath, there will be hypoxia. In most tissues of the body, the response to hypoxia is vasodilation. By widening the blood vessels, the tissue allows greater perfusion.

Also, hypoxia or anoxia can/will cause hypokinesis with a normal (sometimes) EF and that can be picked up on an echogradiogram. I had shortness of breath and ischemia, but the shortness of breath was due to heart failure. The heart was unable to provide adequate oxygenated blood and that stressed the cardio/pulmonary system and SOB.

By contrast, in the lungs, the response to hypoxia is vasoconstriction. This is known as "Hypoxic pulmonary vasoconstriction", or "HPV". The shortness of breath problem in my opinion would have a high probability to be respiratory in nature given the information posted..
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976897_tn?1379171202
Possibly. I am just going by my own experiences which are confusing all cardiologists. I have EF 70%, according to tests good blood flow, perfectly healthy lungs and pulmonary system, yet I get short of breath very quickly. My blood gas is normal which suggests there is no reason for the brain to increase respiration as the PH is showing no irregularities. 9 cardiologists assumed my shortness of breath was due to the blockage in my LAD. All have been proved wrong.
However, I have been getting some new symptoms in the last week, and hopefully when I describe these to the cardiologist next month, it will ring a few bells.
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367994_tn?1304957193
You have numerous stents.  Did you ever have heart muscle damage from a heart attack?
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No, I havent had face any heart muscle damage ..nor havent had heart faliure..the only problem with me is shortness of breath while doing little work..even i need to take deep breath while having my meal..while chewing my avery bite ogf meal..i feel restless..as i feel that my breath is completely stopped while chewing the food.
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976897_tn?1379171202
I wouldn't have thought so with an EF of 70% ? and normal heart dimensions/thicknesses.
Echo/nuclear scan revealed no damage. All I know is that as soon as my heart rate goes over 100 bpm, then the problems start. ECG/Echo show nothing happening.
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367994_tn?1304957193
Here is a link to a thread that may that seems to address your problem.  The doctor's response indicates a possible pulmonary problem.

http://www.medhelp.org/posts/Gastroenterology/Shortness-of-Breath---seeming-to-stem-from-eating/show/228496
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212161_tn?1391090750
so than all the test we run are really no good, because they show us we are fine and we really are not.  i had a stress/nuclar test last year said all was good no problem, last week i had a echo said heart walls and everything normal no problems but we really dont know even with these test that are saying our heart is good. so why have the test.

that makes me not want to do the test.why go throught the stress/money of test if they are not true and dont show when you really have a problem?
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367994_tn?1304957193
QUOTE: "All I know is that as soon as my heart rate goes over 100 bpm, then the problems start. ECG/Echo show nothing happening".

>>>Blood pressure and heart rate compensate each other. When your blood pressure is low, your body raises the pulse rate to push more oxygen through.  When your blood pressure is high, your body lowers the pulse rate to prevent too much oxygen from being in your system.  It creates a balance in your body to maintain homeostasis.

If your blood pressure is lowering, then your heart rate should increase.  Is there an abnormal association with BP and HR?  It would be interesting to determine your blood pressure as your heart rate goes up.
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976897_tn?1379171202
During my recent stress echo, one Doctor continually monitored my BP and ECG, another Doctor slowly infused the stress drugs, another was continually scanning the heart using echo, and another was continually asking how I felt. They slowly took my heart to 185 bpm and they could find nothing wrong with my echo, BP or ECG. Everything looked normal. This really annoyed me because I was in agony with chest pains/throat discomfort. I was also sweating heavily and felt nauseous, for which I was given medication for. I was not panting for breath, this only seems to occur if I'm on my feet. I believe they are using the vasospasm as an excuse, because they witnessed spasms during stenting. However, I think lots of ballooning and stenting plus dissecting the artery would probably make it spasm. I am convinced that CCB help because they act like a beta blocker. To prove this, I will switch from CCB to beta blockers to see if I feel the same. In theory, if spasms are the problem, then I should feel worse, but I believe I will feel the same.
I have theories of my own, but the biggest is that one of the stents has stenosed. I basically feel the same now as I did before the stenting. CCB seemed to work great for a few weeks but have lost their effect for the shortness of breath etc which makes me think the blockage is worsening. I felt better than this after my bypass surgery when the LAD was filled with blood, that was until it failed. So I think when I see my cardiologist next month, I will insist on a CT angio. They seem to be assuming that the stents are fine. One cardiologist said "If there was something wrong with the stents, you wouldn't be here". Surely thats rubbish? If I lived with a total occlusion pre-stenting due to collaterals, then surely if a stent blocks then I will simply return to my old condition?  I'm beginning to feel like I'm going round in circles but I hope a ct will show something obvious.
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976897_tn?1379171202
Please don't feel that all tests are a waste of time. The way to look at them is they don't only look to see what problems you DO have, but they also verify problems you DON'T have.
Tests are a filtering process in the world of logic. A Doctor will put you through a series of tests, filtering out possible problems with your heart until hopefully the reasons are found.
Sometimes, such as my case, you fall through the bottom of all the filters with nothing having been found. These 'unknowns' are a problem to cardiologists and some are given reasons such as vasospasm or MVD. Some of those are accurate conclusions whereas others are not. Research still has a lot to find, but the vast majority have their problems found and are given appropriate treatments.
For example, if a patient has chest pains on exertion, an ECG may look normal, as too may an echo. However, this is good news as it verifies a good electrical system in the heart and the heart has not enlarged to try compensating for its weakness. Further tests are then performed to enter the next stage, such as a nuclear scan, CT angio or a standard angiogram.
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367994_tn?1304957193
QUOTE:"Please don't feel that all tests are a waste of time. The way to look at them is they don't only look to see what problems you DO have, but they also verify problems you DON'T have"

Correct.  It iscalled differential diagnosis.  If all possibilities are ruled out, then the medical community will call it ideopathic.
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