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Mitral Valve/Aorta malfunction and their symptoms

Recently our daughter who has a history of mitral stenosis, and coarchtation of the aorta became very ill.She had been on a medication for migrane headaches called amitriptyline for about 6 months. It was discontinued, but she is still symptomatic.
She began with flu like symptoms, primarily fever and cough. Her cough never went away. The General practiononer said she was in CHF after some tests and she was put on Lanoxin and something to dry the lungs up. She was later upgraded to mitral valve insuffeiciency. When she lays down, she begins to cough worse, to where she prefers to try to sleep sitting up. Along with this she complains of a "grapefruit size lump feeling" in her chest just where the collarbones meet in the front. She wakes at night with Chest pains, one set that runs horizontally from the sternum to the left side of the ribs and one that runs vertically in the center of her chest. She is rarely hungry, Is fatgued and has a very high heart rate.
She has undegone two echos,a cardiac cath,  a stress echo, a 24 harness,  blood profiles (eliminating diabetes, thryroid or other blood/heart related illnesses)in the last two months, with no significant changes from when she was a baby
We are being told that the progression of this should not have been this fast, (over about a four month period of time). We have been evaluated by  pulmonologist to eliminate asthma or breathing difficulties due to lung malfunctions. We were told by this specialist that he thinks she is sufferinf from depression.
(She is very lively and upbeat when she is feeling well, and tries to stay involved with her horses and ice skating) We are concerend it may lead to depression if we cant get some consistency in her days.
I guess i want to know the following:
1)
She just had a VMA test done, showing nothhing too. Is this a normal test to check heart function????

2)Are there other tests we should request?

3)Are her symptoms consistant with mitral valve and aorta problems

4)she wants to know, is it normal for her leg to be sore two months after the echo.

Thank you for your time.
Theresa
6 Responses
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Avatar universal
A related discussion, mitral valve replacement surgery was started.
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Avatar universal
A little over a year ago I had my aortic valve replaced with a St. Jude mechanical valve.  Approximately 6-7 weeks postoperatively, I exhibited sick sinus syndrome and had to have a pacemaker implanted.  Prior to my surgery, the echocardiogram showed mild-moderate mitral regurgitation with a trace tricuspid regurgitation and no pulmonic regurgitation.  My most recent echocardiogram (six months ago) showed mild mitral regurgitation, moderate tricuspid regurgitation, and mild pulmonic regurgitation. The echo also shows evidence of mild cardiomyopathy with mild global hypokinesia. The left ventricle is still larger than normal at 5.8. My ejection fraction remains at about 55%.  However, I went into congestive heart failure approximately six weeks ago. I am on the following medications: hyzaar, cozaar, lasix, lanoxin, potassium, and coumadin.
  My questions are:
      1.  Should ACE inhibitors also be part of my medication?
      2.  Since my tricuspid and pulmonic valves are showing increased signs of regurgitation, can medication alone keep this from getting worse?  Is another surgery eminent?
      3.  Should pressure tests via cath procedure be done?
                         Thanks for your assistance.
                                Skip
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Avatar universal
Thank you very much.
I appreciate your time and responses.
It has been frustrating wondering if our health insurance company is behind limiting the drs on what they say and do.
The drs were heading that way after her stress echo, and all of a sudden things changed, and I wasnt sure if the sypmtoms were maybe something else non related.
Ginny, thank you for your lyme concern, we have sometimes wondered ourselves about that, but dont live or travel in areas where that is a problem. Thank you.
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238671 tn?1189755832
It sounds like she already has definite diagnoses that could account for her symptoms, so I would not recommend those particular tests.
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Avatar universal
Dear Doctor,
Reading Theri's post about her daughter's problems and her hobbies-skating and horses-there may be a problem with Lyme Disease.  This would exacerbate pre-existing heart problems and could explain the rapid progression.  Should Theri have her daughter tested for Lyme and an ANA panel?
Sincerely,
Ginny
Helpful - 0
238671 tn?1189755832
1. This checks for adrenaline excess in the body.
2. If she is having recurrent fevers, infection of the valve should be ruled out.
3. Her symptoms are consistent with severe valve problems. Based on what you have written, she may need surgery.
4. No. The echo is not the cause of these symptoms.
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