rule out endocarditis and is surgery warrented

[rick So.]

I am an active, non-smoking 47 year old male who is of average weight; however, I also have a history of hernia in my cervical disk, enlarged prostrate, and have recently had a small squamous cell carcinoma removed and repair of an abcessed root canal.  I have recently been diagnosed with severe mitral value regurgitation, myxomatous of the mitral value, but "it does not quite proapse".  The Echo report yeilded the following:

LV DIastole:5.6cm;
LV Systole:3.3;
Septrm wall thickness:1.8cm;
Posteerior Wall Thickness: 1.4cm;
Left Atrial Size: 4.4;
Aortic Root: 3.3cm;
Right Ventricle:2.0cm

The "estimated ejection fraction is greated than 55%" The findings suggest"Mildly enlarged LV at end-diastole with mild to moderate concenentric hypertrophy which appears to be asmmetric, although there is no flow tract gradient"...The initial heart mumur was detected as part of a physcial done 3weeks ago.  My previous physical was done 1.5-2 years ago and no mumur was detected.  For several years I have had eposodic discomfort in by left pectoral,shoulder, bach and neck areas, which is not effected by exercise.  I have also had periods of light headedness and seem to feel very tired by the end of the day.Recently my tempertue fluxuates between normal and 99.5. I had a stress test completed over two years ago to investigate many of these symptoms (no echo was performed then) and it was normal. Over the past two months I have had an ebcessed root canal repaired a squamous cell removed.  Give this presentation: 1)Should i be worked up for endocarditis? If so, what kind of work up? 2)Should I consider surgery now or later? 3)Would some one with my presentation be a candidate for repair or replacement? 3)Would minmumlly invasive procedues be viable? 4) should I excercise, if so, how much?

[Cleveland Clinic, MD]

Dear rick, At the Heart Forum we try to provide education and information concerning heart related topics.  Your questions deal more with case management which is highly variable depending on a multitude of factors.  The answers we could give would be inadequate for determination of what should be done and thus are really better addressed by your cardiologist.  Best wishes.