What is the prognosis for a patient with mild or mild to moderate MR due to congenital MVP if the patient presents with chest pain and pulmonary edema upon exertion? In this case the patient has no dyspnea except with exertion, and both pain and edema are relieved after resting. Pulmonary hypertension is not present at rest and there is no history of MI.
How does the prognosis differ from a patient with mild to moderate MR who is asymptomatic (no edema on exertion)?
Studies demonstrate that MR worsens significantly in some patients during exercise. I'd like to know if this change during exertion affects a patient's overall prognosis and their need for valve repair/replacement.
Generally speaking, mitral valve prolapse can certainly be associated with chest pain that has not been well defined as to why this occurs. Shortness of breath can certainly be attributable to mitral valve reurgitation. The degree of regurgitation, along with other well defined variable (one of wich is pulmonary hypertension) and symptoms help make the decision of when mitral valve surgery is indicated. Exercise testing with a echocardiogram is an excellent way to test to see what happens when you exercise (if the regurgitation increases, if the pulmonary pressures increase, and it also defines exercise tolerance). Symptoms are always important, especially if they are associated with more severe mitral regurgitation. Mild regurgitation, associated with symptoms or not, incurs no change in prognosis.
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