wierd symptoms, stressful test results

I had an EKG  performed prior to asurgery that was not heart related. The results stated that it showed a possible enlarged left atrial or ventrical.  I then had an ECHO Cardiogram performed which showed no enlargement but showed both mild mitrial and tricuspid regurgitation and repeated a low L.V. diastolic measurement of 40mm. My left atrium and aortic root are both on the high side of the measurement scale; both are 32mm respectively.
I have had all of the symptoms for years; weakness, fatigue, repeated episodes of edema, unexplained shortness of breath, shortness of breath when I exert myself, most things cause me to cough excessively. I even had all the symptoms of a mild heart attack (chest pain, dizziness nausea, sweating, felt as if I would pass out) but I blew it off because I had these frequently and it only turned out to be gallstones that led to my gallblader (gallbladder) colapsing and severe pancreatitus (pancreatitis).  I also took high doses of Phentermine for almost a year until Had to be treated for high blood pressure for 2 years before it returned to normal.  My father and cousin have a history of heart problems/irregularities.

With these test results(which frankely have me stressed out) and my history, how likely is it that I will be looking at surgery to repair those two valves?  Should I be worried that the current condition could in all likelyhood become progressively worse? What should be my next course of action? if heart meds are recommended and will only prolong the inevitable, wouldn't it be in my best interest to go ahead with the surgery as soon as possible? I am already close to 50 years old.

Thank you for your help because I really do not know what to do, and I am pretty sure this is or can become serious.

[Jack54]

Morning to you :)

According to my recent echo, and using the "normal range values" listed on it, (which I do not know whether or not they differ across the country, like other lab work normals) it doesn't appear you have any enlargement of any dimensions you mentioned. The 3.2 cm (32mm) you listed for your left atrium is well within range: 2.4-4.0 cm. The same goes with your Aortic root: 2.2-3.7 cm.

In fact, the low end of the normal range for LV diastolic is 4.0 cm. I think that I would celebrate this at age 50? Not sure, but I would ask my cardiologist about this.

The phentermine that you took for a year, has not been reported to have caused any heart valve disease/changes/damage, that I can find. As you well know, phentermine is an appetite suppressant of the amphetamine and phenethylamine class, and is probably not good for the heart due to the resulting increased heart rate. It sure doesn't appear that it caused enlargement of any of your heart chambers, and that is a problem with years of amphetamine abuse.

The combined phentermine with fenfluramine or dexfenfluramine, which became known as Fen-Phen, was fatal to a number of people, and there are still people living who have extensive valve damage. My Son-in-law's Mother recently died due to complete failure of her aortic valve. She was an RN.

Are you sure that your valve leakage is noted as mild, not trace? There is a substantial difference in this description, I have read. At you age, trace or maybe even mild leakage would not be remarkable. A high percentage of the population, especially at our age, have some valve leakage. I would have regular echocardiograms to monitor changes in size and leakage.

Have you ever been diagnosed with MVP or MVR? This/these conditions usually precede(s) mitral valve leakage.

I think that part of your problem is the thoughts of, or anxiety from taking large doses of phentermine in the past, and the deathly illness that pancreatitis causes. I once had a doctor to tell me that pancreatitis was one of the worse conditions to endure and survive. My grandmother died of pancreatitis. Hyperlipidemia runs in our family.

You asked "wouldn't it be in my best interest to go ahead with the surgery as soon as possible?".  You have to be evaluated for valve repair/replacement. You would also be experiencing symptoms from your MVR or mitral valve leakage if it were a problem. Probably fairly severe symptoms before they would consider surgery.

Take what I tell you with a grain of salt, and don't believe any technical aspects written :) I know that people with questions do not want to hear "go see your doctor about this", so I try to do research for people. There are very knowledgeable nurses here that can be a big help. Myself, I am a farmer :)

Jethro

[lillius]

I had a echo done last week on my heart. my results came back with a normal heart but there is a slight leakage across the mitral valves and tricuspid valves.What should be done about this is it not a real concern.

[kenkeith]

Mild, trivial, trace, etc. of heart valves are considered medically insignificant and almost always never progresses.  Not an uncommon condition!