Could I get some opinions on this, please?

[luvwinnie]

My friend, age 35, was told today she has trivial tricuspid regurgitation, dilated left atrium and left ventricular hypertrophy. She was diagnosed with high BP and treated over a year ago. She had an echo 2 yrs ago that was NORMAL. Amazing how things can change in 2 years (I'm due for an echo in Jan. for MVP, makes me wonder). Dr. is putting her on betablocker now and back on diuretic. He feels the high BP caused this...I know you guys aren't doctors, but I also know you are all very well-informed...has anyone been through this because of high BP? When I think of all my mom went through for YEARS with her heart, I can't believe just a year or so of high bp (which seemed to be controlled) could cause all this.

Oh, my friend has also had very high cholesterol and Hashimoto's thyroid disease.

Thank you.

 

[Johnny Stephens]

I'm very sorry that your friend is having this problem.

[standard, I'm not a doctor disclaimer here]

First of all, I believe that "trivial" tricuspid regurgitation is quite common. I was told by an echo tech in the hospital that "everybody's tricuspid valve leaks a little bit." She further explained that some of the extrapolations they must do to diagnose pulmonary hypertension actually depend on this fact.

I'm not sure about the atrial enlargement, but the left ventricular enlargement is a classic result of extended exposure to high BP. While her treatment for hypertension was initiated a year ago, is it possible it went on for an extended time before that?

I had an echo in 1999 that showed my valve stenosis was "medically insignificant". I was told to recheck it in 2yrs, as I'd been on Redux. In late 2001, I started not feeling well, and the follow-up echo showed my stenosis had gone to the "severe" stage. So, yes, things can change rapidly.

I also suffer from Hashimoto's, but I don't think this would be a factor.

 

[ALCapshaw2]

I *assume* these findings are from an Echo.
Is that correct? Were there any other VALVE related symptoms?

My *guess* is that a dilated left atrium and LVH 'could' result from high blood pressure. Hopefully her BP meds can reduce this. When did her Doc want to recheck with another echo? Hopefully not more than a year, preferably in 6 months.

She should be monitored REGULARLY from here on out IMHO.

'AL'

 

[luvwinnie]

Thank you. Yes, it was an echo. NOt sure he mentioned yet about the next echo.

 

[Bryan B]

I believe the echo guidelines for valve leakage are as follows:

trivial
mild
moderate
severe

You may see results that say something like "moderate to severe" meaning it's somewhere between moderate and severe. My echo pre-op showed that I had moderate aortic, trivial mitral, and mild to moderate tricuspid leakage. It turns out that what appeared to be tricuspid leakage was really some "turbulence" caused by my VSD.

As for her dilated left atrium and left ventricular hypertrophy, the only thing I would be confident in saying is that I doubt it was caused by trivial valve leakage.

 

[tobagotwo]

Trivial means ordinary. Many, perhaps most people have on and off trivial tricuspid leakage. Only Harpoon made a big deal out of it...

It is likely without any bearing on the rest of her condition. She does not seem to currently have valve disease. The echo would be to track for further heart enlargement, presumably from her high blood pressure, or other undiagnosed issue. I think annual, rather than semiannual, but I'm no doctor, either.

It's still no fun. Sorry she has to go through this.

Best wishes,

 

[Harpoon]

HEY HEY!

Ain't nothing "trivial" 'bout MY tricuspid valve leakage!!!

Damned thing nearly killed me!!!


Anyways, getting back to reality (so DULL and boring I know, but we must...)


Don't discount those findings at all and make SURE your doctor intends to order a follow-up echo within six months.

A LOT can change in that time.

She should keep an eye out for stuff like water retention and any signs that other symptoms might be getting worse.

Early on I was put on an ACE inhibitor which was to help seal up that leak in the tricuspid valve. ACE inhibitors are more typically used to control high blood pressure and in her case, it might be good for both. I was on lisinopril, still on it today though at a different dose. I've also been on Diovan which has a similar effect but costs MUCH more.

I don't have prescription drug coverage so cost is important to me. =)


By the way, my triscupid "failure" was more or less a natural result of the way my heart was reconstructed to correct a congenital heart defect called transposition of the great vessels so don't get alarmed by the stuff I said about tricuspid valve leakage leading to a premature demise...

My heart's been "bass ackwards" since day one and it was only a matter of time before something inside my chest broke.

 

[Shine_on_Syd]

Just the other day my cardio said they generally don't replace tricuspid or pulmonic valves. When he listened to my heart before looking at the echo and said I had a leaky pulmonic valve, I reminded him that is why my Ross was aborted because the surgeon said my pulmonic valve looked like it went through a "meat grinder"

 

[Bryan B]

What Harpoon said about the ACE inhibitors reminded me that was one option my surgeon gave me if I was totally against having the surgery now instead of later. My left venticle was at upper limits of normal and the ACE inhibitors may have slowed (or possibly) reversed that process. He said it would have been a temporary fix that may or may not work and I would have to be on it for 6 months to a year before we would be able to tell if it was effective. He also believed that I would still need surgery within the next 5-10 years, best case scenario, and another bout of endocarditis (that I had just gotten over) would make surgery more complicated and emergent. I had already been told by my cardio and the first surgeon I consulted with that surgery was my best option, so I chose to go with the surgery becuase I had already accepted the idea of having it done.

 

[luvwinnie]

Thank you all. What bothers is that she HAS BEEN retaining fluid for about a year and was given a diuretic but no one ever bothered to REALLY look into WHY.