A
ASaxon
Mitral Valve Hypertrophy or Dilated Cardiomyopathy
Hi everyone, I?m new to this and trying to figure out what my problem is. I found this site and thought I?d post my situation and see what your opinions may be.
I?m 38 years old and about 4 years ago I started having symptoms of extreme palpitations which caused anxiety and a few frantic trips to the ER. Each time they could not find anything wrong with me. Since then I?ve had a number of tests to try to identify my problem and here?s what they found, or didn?t find as the case may be.
Chest x-rays were normal
ECG was/is normal with a slight Right Bundle Branch Block (hardly detectable)
Had a Thalium nuclear stress test two years ago which I passed with no abnormalities.
Holter monitor showed only a few single PVCs and no abnormal rythums except for bradycardia dropping down to mid-to-low 40?s during sleep.
Event recorder showed no abnormalities while feeling fluttering in my chest or back area, could have just been anxiety.
No adverse arrhythmias have ever been detected.
Had an echocardiogram two years ago with borderline measurements for wall thickness (IVSd=1.1cm, LVs=1.2cm), Left Ventricle Diastolic Diameter (LVd=5.9cm), Left Atrium Systolic Diameter (LAs=4.5cm), an Ejection Fraction of 67% with no mention of mitral valve regurgitation.
Had a follow up echocardiogram one year ago with the following results: Mild to Moderate wall thickness (IVSd=1.4cm, LVs=1.6cm), mild Left Ventricle Diastolic Diameter (LVd=6.2cm), Left Atrium Systolic Diameter (LAs=5.2cm), an Ejection Fraction of 71% with the following mitral valve analysis.
Mitral Valve ? Normal anatomy and motion with normal peak flow velocity without stenosis, prolapse or vegetation. There is mild mitral regurgitation seen at peak elocity of 4.2 m/sec going back approximately half way to the superior left atrial border occupying no more than 10-20% of the left atrial volume on the color flow map.
No doctor has ever been able to hear any murmur or abnormal sound with a stethoscope. My doctor tells me that this may be because I?m so big (6?1?, 300+ lbs) as this can make it difficult to hear faint abnormal heart sounds.
When going over the results of the second echocardiogram with my doctor he said that he wasn?t sure about the measurements of either of the echos. First he said that progression of concentric cardiomyopathy was way too fast to go from IVSd=1.1 to 1.4cm and LVs=1.2 to 1.6 in just one year. He guesses that the first echo under measured my heart wall thickness and the second one over measured it. He said that the measurement error for echocardiograms could be as high as 0.3cm. With this interpretation he estimated my actual heart size to be LVs=1.2 or 1.3cm and LVs to be around 1.4cm which he classified as mild hypertrophy.
He put me on more aggressive blood pressure medications and suggested I loose 100 lbs as I am morbidly obese. My blood pressure was hanging around 130/80 and after increasing my BP meds and loosing 20 lbs (to start) it dropped to 110/65. I continued to exercise and loose weight and lost 40 lbs. His impression was that when my blood pressure is high my mitral valve regurgitates and is the source of the dilated and hypertrophied left ventricle and that the reason the first echo didn?t show regurgitation was because I was exercising and my blood pressure was lower so the regurgitation wasn?t seen. Does this make sense to anyone?
Unfortunately I fell into some depression and gained all the weight back and now I?m in the process of loosing it again through diet and exercise.
My Questions:
1. Anyone have any opinion on how mild or severe my hypertrophy is in relation to mitral valve regurgitation?
2. Is my hypertrophy indicative of it being cased by mitral valve regurgitation?
3. Is it true that before controlling my blood pressure my mitral valve could have been leaking even worse than what was on the second echo thus causing my left ventrical hypertrophy and atrial enlargement?
4. If the regurgitation stops with continued weight loss and well controlled blood pressure, would the previous remodeling stop and progression to heart failure avoided? I know no one has a magic ball but I?m sure you all know about studies done for this and I?m so new to this subject I thought I?d ask your opinion.
5. Should loosing weight and controlling blood pressure be the only treatment at this point? Should I consider valve repair or wait for progression of the regurgitation and hypertrophy?
6. Is it possible that the hypertrophy is not related to mitral valve regurgitation and is actually pre-cardiomyopathy? My ejection fractions are high 68 and 71% so this doesn?t seem to be indicative of a cardiomyopathic process.
7. Any suggestions on what I should do or if I should worry about this so long as I keep my blood pressure under control and loose weight?
This whole thing has made me very nervous and I?m concerned about my future. Can anyone help me understand this?
Thanks!!!
Hi everyone, I?m new to this and trying to figure out what my problem is. I found this site and thought I?d post my situation and see what your opinions may be.
I?m 38 years old and about 4 years ago I started having symptoms of extreme palpitations which caused anxiety and a few frantic trips to the ER. Each time they could not find anything wrong with me. Since then I?ve had a number of tests to try to identify my problem and here?s what they found, or didn?t find as the case may be.
Chest x-rays were normal
ECG was/is normal with a slight Right Bundle Branch Block (hardly detectable)
Had a Thalium nuclear stress test two years ago which I passed with no abnormalities.
Holter monitor showed only a few single PVCs and no abnormal rythums except for bradycardia dropping down to mid-to-low 40?s during sleep.
Event recorder showed no abnormalities while feeling fluttering in my chest or back area, could have just been anxiety.
No adverse arrhythmias have ever been detected.
Had an echocardiogram two years ago with borderline measurements for wall thickness (IVSd=1.1cm, LVs=1.2cm), Left Ventricle Diastolic Diameter (LVd=5.9cm), Left Atrium Systolic Diameter (LAs=4.5cm), an Ejection Fraction of 67% with no mention of mitral valve regurgitation.
Had a follow up echocardiogram one year ago with the following results: Mild to Moderate wall thickness (IVSd=1.4cm, LVs=1.6cm), mild Left Ventricle Diastolic Diameter (LVd=6.2cm), Left Atrium Systolic Diameter (LAs=5.2cm), an Ejection Fraction of 71% with the following mitral valve analysis.
Mitral Valve ? Normal anatomy and motion with normal peak flow velocity without stenosis, prolapse or vegetation. There is mild mitral regurgitation seen at peak elocity of 4.2 m/sec going back approximately half way to the superior left atrial border occupying no more than 10-20% of the left atrial volume on the color flow map.
No doctor has ever been able to hear any murmur or abnormal sound with a stethoscope. My doctor tells me that this may be because I?m so big (6?1?, 300+ lbs) as this can make it difficult to hear faint abnormal heart sounds.
When going over the results of the second echocardiogram with my doctor he said that he wasn?t sure about the measurements of either of the echos. First he said that progression of concentric cardiomyopathy was way too fast to go from IVSd=1.1 to 1.4cm and LVs=1.2 to 1.6 in just one year. He guesses that the first echo under measured my heart wall thickness and the second one over measured it. He said that the measurement error for echocardiograms could be as high as 0.3cm. With this interpretation he estimated my actual heart size to be LVs=1.2 or 1.3cm and LVs to be around 1.4cm which he classified as mild hypertrophy.
He put me on more aggressive blood pressure medications and suggested I loose 100 lbs as I am morbidly obese. My blood pressure was hanging around 130/80 and after increasing my BP meds and loosing 20 lbs (to start) it dropped to 110/65. I continued to exercise and loose weight and lost 40 lbs. His impression was that when my blood pressure is high my mitral valve regurgitates and is the source of the dilated and hypertrophied left ventricle and that the reason the first echo didn?t show regurgitation was because I was exercising and my blood pressure was lower so the regurgitation wasn?t seen. Does this make sense to anyone?
Unfortunately I fell into some depression and gained all the weight back and now I?m in the process of loosing it again through diet and exercise.
My Questions:
1. Anyone have any opinion on how mild or severe my hypertrophy is in relation to mitral valve regurgitation?
2. Is my hypertrophy indicative of it being cased by mitral valve regurgitation?
3. Is it true that before controlling my blood pressure my mitral valve could have been leaking even worse than what was on the second echo thus causing my left ventrical hypertrophy and atrial enlargement?
4. If the regurgitation stops with continued weight loss and well controlled blood pressure, would the previous remodeling stop and progression to heart failure avoided? I know no one has a magic ball but I?m sure you all know about studies done for this and I?m so new to this subject I thought I?d ask your opinion.
5. Should loosing weight and controlling blood pressure be the only treatment at this point? Should I consider valve repair or wait for progression of the regurgitation and hypertrophy?
6. Is it possible that the hypertrophy is not related to mitral valve regurgitation and is actually pre-cardiomyopathy? My ejection fractions are high 68 and 71% so this doesn?t seem to be indicative of a cardiomyopathic process.
7. Any suggestions on what I should do or if I should worry about this so long as I keep my blood pressure under control and loose weight?
This whole thing has made me very nervous and I?m concerned about my future. Can anyone help me understand this?
Thanks!!!
