Moderate MVR/ mild TVR with Moderately dilated Left atrium

Question

I am a 44yo/F who recently had a TEE that showed: Left ventricular Upper normal size with low normal LV function ~55%. Right ventricle normal, Left atrium is moderately dilated, right atrium normal in size and structure, Mitral valve moderate regurgitation, Tricuspid valve mild regurgitation visualized. I'm always tired, I spend most days in bed and I have palpitations, headaches, angina, I experience fatigue after standing longer than 15 minutes or more. I'm short of breath after a short walk, I've been been 5th is way for over two years. I was originally diagnosed with MVP in 1999. I've been seen by two different cardiologists: one suggested surgery the other says immediate surgery is not needed. My question is, would it be better to have surgery to correct these issues now while my heart is strong or to wait until it becomes severe and other symptoms begin like AFib or leakage into my lungs? I'm in Georgia and I have tried to talk to both physicians about this issue and i feel like they blow me off or get tired of answering my questions. I have 4 children and need to make the best choice for myself and for them. I need a professional view from someone who genuinely cares. Thank you in advance. I will continue to pray on this.

This discussion is related to Myxomatous mitral valve.

BrokenHeartedLadyof4 · Answer

Thank you so much. I truly appreciate you taking the time to respond. Many blessings to you.

Ger57 · Answer

Hi,
let me start by saying that valve leakage is not very rare. With many people, echos show more or less regurgitation, mostly trace or mild however.
When the regurgitation is moderate or severe, more monitoring is needed to see if it progresses and if it affects the heart sizes/shapes.

Mild tricuspid regurgitation is not a real problem.
In the longer term, moderate/severe mitral regurgitation can cause overload of the left heart, often starting with enlargement of the left atrium. This is something to stay ahead of, because it is the start of lots of irreversible heart trouble, like afib, hypertrophy of left ventricle etc. 

Carefully planned mitral repair surgery is the way to go in this situation.
The best moment for repair is not only defined by the current situation but also by the speed at which things are progressing.

In your case, with moderate dilated left atrium, it seems to me that your heart has already started to compensate. I would really consider getting the surgery done soon to avoid irreversible damage to your heart. 

Another very good reason for not waiting any longer is that you are suffering too much from the effects of your heart condition. 
You need to be able to take care of your children and you can not do that when you are spending days in bed and feeling the way you describe.

Good luck.