regurgitation

Posted By Kristi on August 20, 1998 at 14:45:07:







I am a 27 year old female with a hx of acute bacterial endocarditis (staph)
that occurred at age 12. Following a 2-month hospitalization, a resulting
murmur and prolapse of the mitral valve were diagnosed. I have had yearly echos since
then (and was seen at Johns Hopkins) and the regurgitation has always been
about a 3+. I have always been very active - I am 5'5" and 117lbs. and exercise 4-5x/wk (tennis, walking,
light weights, etc.) I have never had any symptoms at all related to this
diagnosis until recently. In the past 3 weeks, I have had very sharp chest
pains when exerting myself (not related to inspiration), and extreme
fatigue. I went to my cardiologist who did another echo, and now the
regurgitation is a 4+ (backflow into the pulmonary vein).
However, no enlargement of the heart was noted and my lungs were clear in
the chest X-ray.
He wants me to do a stress test next week as I never had difficulty exercising until
recently.
My questions are: 1.Can the chest pain and fatigue be related to the
                  increase in severity of the leak? (My doctor didn't
                  seem to think it was related)
                  
                  2.Is surgery ever recommended with a 4+ regurgitation
                  even though the heart is not enlarged yet (and is once
                  the heart is enlarged, does it revert to normal once the
                  valve is repaired)?
                  3.Given the severity of the leak, would pregnancy pose a
                  risk to my health (due to the increase in fluids)?
Thank you for your help!