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Heart Disease (Expert Forum)
parachute mitral valve & stenosis of both aortic & mitral valves
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parachute mitral valve & stenosis of both aortic & mitral valves
by Marie__0__0, Oct 30, 1998 12:00AM
Dear Doctor,
On August 1 1998, my 12 yr old granddaughter went for a school physical,
and at that time was diagnosed with a murmur. We were sent to Children's
Mercy Hospital on August 17 and she was diagnosed with mitral stenosis,
aortic stenosis & aparachute mitral valve. She was born with this, they
tell us and for some reason it is now making itself known. They told us
that the stenosis is moderate and there is no shunting of blood & no
hypertrophy at this time . She compensates by increasing her heart rate.
She is not a candidate for balloon valvuoplasty or commissurotomy
because the valves are deformed and will have to be replaced. I have
some questions that I would like to ask and any help would be appreciated. How much more can the valves stenosis before something
needs to be done and will they stenosis more? How soon will the valves
need to be replacedand is ther any way to know what vale will go out
first? Should we wait that long? Can both valves be replaced at the same
time? Alsohow common is it for a child to be born with both valves deformed ? How to we know when the stenosis started & the parachute
mitral valve developed? Is there certain signs & symptoms do we need to
watch for,also what deprhythmies? Is ther any type of antioagulants or
special medications that she should be on at this time? Are people who
have valve replacement able to have children, and I guess the last one
question I want to ask, is there a chance she will make it to an adult
before she has to have the valves replaced? We can't find any information
on parachute mitral valve, so if you can tell where to find anything about
it, we would apprecited it. Thank you for your time, sincerely, Marie
Doctor's Answer
by CCF Cardio MD - MTR, Oct 30, 1998 12:00AM
_
Dear Marie, thank you for your question. A parachute mitral valve refers to a myxomatous, degenerative mitral valve that has mitral valve prolapse (MVP). Your granddaughter has a rare constellation of valvular lesions. I'll answer each of your questions individually.
1. How much more can the valves stenose before something needs to be done and will they stenosis more? Valvular stenosis can progress rapidly or can progress very slowly. It's difficult to tell how the degree of stenosis will progress in an individual person, though.
2. How soon will the valves need to be replaced and is there any way to know what valve will go out first? Should we wait that long? The timing of valve replacement is highly individualized and only your granddaughter's pediatric cardiologist can determine this crucial decision. I suggest that you follow his/her advice on this issue and do not try to accelerate the timing of this decision.
3. Can both valves be replaced at the same time? Yes, if necessary.
4. Also how common is it for a child to be born with both valves deformed ? This is rather uncommon but I can't quote you incidence rates.
5. How do we know when the stenosis started & the parachute mitral valve developed? At this point, how and when the valve stenosis and parachute mitral valve developed cannot be determined and should not important to her subsequent management.
6. Are there certain signs & symptoms we need to watch for,also what about dysrhythmias? Shortness of breath with exertion, chest discomfort, and fatigue are the general signs you need to look our for. Rhythm disturbances of the electrical conduction system of the heart can occur with MVP and the valvular lesions that she has. You should look for an accelerated heart rate of > 100 when she's not exercising to signify she may be having an arrhythmia.
7. Are ther any type of antioagulants or special medications that she should be on at this time? I can't determine this, only her cardiologist can.
8. Are people who have valve replacement able to have children? If a patient with a valve replacement is required to take coumadin long-term after the valve replacement, then pregnancy is contraindicated. Coumadin can harm the fetus early during gestation. The only other option would be to take daily subcutaneous heparin injections during the pregnancy as a substitute for coumadin.
9. Is there a chance she will make it to an adult before she has to have the valves replaced? I don't have a good answer to this question because I have never examined your granddaughter. Only her cardiologist can answer that.
10. We can't find any information on parachute mitral valve, so if you can tell where to find anything about it, we would apprecited it. There may some websites on mitral valve prolapse, but with the combination of valve disorders that your granddaughter has, I don't think those sources of information will relate to her. Your best bet would be to ask her cardiologist about sources of information.
We have a number of excellent pediatric cardiologists here who may be able to help you. Try contacting Dr. Daniel Murphy or Dr. Lourdes Prieto at the numbers listed on their website listings (the website address is listed below). In the meantime, good luck with your pursuit of more information and try speaking with her cardiologist for more specific information.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Dear Marie, thank you for your question. A parachute mitral valve refers to a myxomatous, degenerative mitral valve that has mitral valve prolapse (MVP). Your granddaughter has a rare constellation of valvular lesions. I'll answer each of your questions individually.
1. How much more can the valves stenose before something needs to be done and will they stenosis more? Valvular stenosis can progress rapidly or can progress very slowly. It's difficult to tell how the degree of stenosis will progress in an individual person, though.
2. How soon will the valves need to be replaced and is there any way to know what valve will go out first? Should we wait that long? The timing of valve replacement is highly individualized and only your granddaughter's pediatric cardiologist can determine this crucial decision. I suggest that you follow his/her advice on this issue and do not try to accelerate the timing of this decision.
3. Can both valves be replaced at the same time? Yes, if necessary.
4. Also how common is it for a child to be born with both valves deformed ? This is rather uncommon but I can't quote you incidence rates.
5. How do we know when the stenosis started & the parachute mitral valve developed? At this point, how and when the valve stenosis and parachute mitral valve developed cannot be determined and should not important to her subsequent management.
6. Are there certain signs & symptoms we need to watch for,also what about dysrhythmias? Shortness of breath with exertion, chest discomfort, and fatigue are the general signs you need to look our for. Rhythm disturbances of the electrical conduction system of the heart can occur with MVP and the valvular lesions that she has. You should look for an accelerated heart rate of > 100 when she's not exercising to signify she may be having an arrhythmia.
7. Are ther any type of antioagulants or special medications that she should be on at this time? I can't determine this, only her cardiologist can.
8. Are people who have valve replacement able to have children? If a patient with a valve replacement is required to take coumadin long-term after the valve replacement, then pregnancy is contraindicated. Coumadin can harm the fetus early during gestation. The only other option would be to take daily subcutaneous heparin injections during the pregnancy as a substitute for coumadin.
9. Is there a chance she will make it to an adult before she has to have the valves replaced? I don't have a good answer to this question because I have never examined your granddaughter. Only her cardiologist can answer that.
10. We can't find any information on parachute mitral valve, so if you can tell where to find anything about it, we would apprecited it. There may some websites on mitral valve prolapse, but with the combination of valve disorders that your granddaughter has, I don't think those sources of information will relate to her. Your best bet would be to ask her cardiologist about sources of information.
We have a number of excellent pediatric cardiologists here who may be able to help you. Try contacting Dr. Daniel Murphy or Dr. Lourdes Prieto at the numbers listed on their website listings (the website address is listed below). In the meantime, good luck with your pursuit of more information and try speaking with her cardiologist for more specific information.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
