Hi Katie, I'm really sorry if I upset you. I feel just terrible. I decided to go back and find the actual article that I had read it on. Below I've enclosed the message that is posted on The Heart Forum:
Q phoenixdoc
(29-Nov-03) . I was recently diagnosed with moderate (2+) MR. My doc put me on 50mg Atenolol (B-blocker) to help with the discomfort. However, the level of discomfort I am feeling seems out of proportion with the level of MR? Is it normal for moderate levels of MR to cause a lot of chest pain and shortness of breath? And, what is that weird "elevator ride" feeling I get in my chest all the time? He increased my dosage to 50 (was 25) after I had two days of it continuously. I am seeing a cardiologist Monday but was just curious what that was. How do I know when to ignore the chest pain and when to seek care immediately? What is the benefit of b-blockers over ACE inhibitors? Thanks.
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CCF-M.D.-RCJ
(29-Nov-03) phoenixdoc phoenixdoc,
Thanks for the post.
Q1:"Is it normal for moderate levels of MR to cause a lot of chest pain and shortness of breath?"
Chest pain is unusual with MR -- but it does depend somewhat on what the pain feels like. If it is a tightness, like that sometimes experienced when a person is short of breath, then it is not totally unusual. Other types of pain should prompt an evaluation for an alternative source of the pain.
Shortness of breath is the chief manifestation of MR in most people. 2+ MR is not often thought of as causing much in the way of symptoms in most people, for that reason 2+ MR is most often referred to as "non-surgical". If you are having a lot of symptoms with 2+ MR then either (1) you are one of the unlucky ones who's symptoms are out-of-proportion to the MR, (2) the MR has been underdiagnosed, or (3) something else explains your symptoms (like coronary artery disease).
Q2:"what is that weird "elevator ride" feeling I get in my chest all the time?"
No idea. I've never heard someone describe this sensation in relation to MR. I'll file it away for the next time someone says this.
Q3:"How do I know when to ignore the chest pain and when to seek care immediately?"
This is the million dollar question. For first-time chest pain sufferers who have not sought attention form a health care provider, I generally tell then to seek attention promptly. The specifics of your chest pain, as well as your previous evaluation will have to dictate when you should seek attention. Certainly any worsening of the pain should prompt evaluation regardless of previous evaluation.
Q4:"What is the benefit of b-blockers over ACE inhibitors?"
In patients with MR, beta-blockers can actually worsen the MR and would not be considered first-line therapy by most cardiologists. ACE-I are considered a temporizing measure to minimize symptoms in patients with symptomatic MR while they await surgery.
Hope that helps.
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Katie, The above is the message that I read about the beta blocker. Its posted on The Heart Forum - The website is:
www.medhelp.org/per16/cardio/messages/C34364-6.html
I would like to ask the Heart Forum a few questions regarding this - but they only allow two posts per day and I don't think it's Eastern Time because everytime I try to post a message - they are not taking anymore questions. That last paragraph is what upset me.. If you can post a question - please ask him where he got his information about beta blockers and MR. I can't find any other posts that says that. I think its a Cleveland Clinic Website - a well respected doctor - that's why I wanted to do a follow-up. Perhaps I'm misunderstanding his post. Or perhaps it applys to something that doesn't apply to me.. I don't know - I know I was upset when I read it.. as I take a beta blocker and I have MR. So I didn't know what to think and thought I would ask if anyone here on this board has heard of such a thing. Figureing that with alot people with MR here - that they may have been told the same thing by their docs.. I asked several other medical people and they didn't think it was true. I don't know.. I "wish" I could "understand" why the doctor in his message said that about beta blockers and MR. I found it most upsetting and was trying to find some validity to his message.
Good Luck
Take Care
Runner
