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echocardiogram results

This is partial results from an echo I had done last July.  At the time I asked them about the mitral valve regurgitation and they told me "we're watching that".  Since then I've had a cardiologist, electrophysiologist, and internist tell me they don't hear anything with a stethoscope.  I'm a runner and concerned my fitness level could be masking symptoms.  I'm 63 years old and have a pacemaker.  I'm unsure how or if to pursue the mitral valve issue.

Value Indexed Value
Max aortic dimension 3.6 cm 1.95 cm/m²
Left atrium diameter 3.7 cm (2D)
Left atrial volume 77.1 ml (Area-Length) 41.9 ml/m²
LV ID (diastole) 5.1 cm (2D)
LV ID (systole) 3.9 cm (2D)
IVS, leaflet tips 0.8 cm (2D)
Posterior wall thickness 0.7 cm (2D)
LV stroke volume 82 ml (2D biplane)
LV end diastolic volume 124 ml (2D biplane) 67.1 ml/m²
LV end systolic volume 42 ml (2D biplane) 22.8 ml/m²
Ejection Fraction 66 % (2D biplane)
There is moderate (2+) mitral valve regurgitation. The pressure half time is 51
msec. The peak mitral E/A ratio is 1.46. The average mitral E/e" ratio is 6.6. The
mitral flow deceleration time is 174 msec
The left ventricle is normal in size. Left ventricular systolic function is
normal. EF = 66 ± 5% (2D biplane) LV diastolic function is probable for stage 2
- The right ventricle is normal in size. Right ventricular systolic function is
- The left atrial cavity is moderately dilated.
- There is moderate (2+) mitral valve regurgitation
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1 Answers
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Avatar universal
Mitral regurgitation is a challenging diagnosis.  The first thing to know is that the echocardiogram is much more sensitive than the stethoscope for detecting mitral regurgitation, so it's not suprising that no one has heard a murmur of mitral regurgitation, particularly if they didn't have you do any special maneuvers.  

The first question is: are you symptomatic?  Do you have shortness of breath or atrial fibrillation?

The consensus in the cardiovascular community is that mitral regurgitation of moderate severity is best observed until and unless it worsens or becomes symptomatic. The best treatment in the interim is good blood pressure control.

If you're uncertain, consider getting a second opinion.
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