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MV prolapse regurgitation

Hello
47 year old, 2.5 years ago I was diagnosed with MV regurgitation with prolapse. I dont have symptoms like shortness of breath .
6 months before this I was diagnosed with High Blood pressure, which I never had in my life.
I dont have any major illness .
Since visited cardiologist first time , I had 5 echocardiagrams and 2 TEE's , as well as some other procedures like Carotid etc.

In those echo's the result was medium/severe mitral valve regurgitation with prolapse
My cardiologist kept telling me we should watch and wait , I moved to a new city and now my new cardiologist says I should have the surgery because LV got bigger.
He asked for a TEE which confirmed :
Severe Regurgitation with posterior leaflet prolapse , likely a fail segment
LV: Moderately dilated
LA: Moderately dilated

I wanted to ask whether anyone had similar experience? Any tips?

A few things dont makes sense to me.
First of all some of the echos said I have posterior prolapse some said its anterior some said its bi-leaflet.
1) How come they cant identify which leaflet?
The last TEE says "likely a flail segment" , so they are not sure again whether I have a flail or not

2) The LA and LV sizes were going up and down +- 10%, is this human mistake when measuring?

3) The echo's were alternating between moderate/severe and severe regurgitation, again is this human mistake ?

Below are the echo details:

8/2020 echo:
EF :57%
LA :4.2 cm ( dilated)
LVIDd: 5.5 cm
Moderate/Severe Regurgitation
moderate prolapse of mv leaflets

2/2021 echo:
EF: 60%
LA:4.3 cm (dilated)
LVIDd: 5.1 cm
Severe Regurgitation
Anterior and posterior prolapse

6/2021 Echo:
EF : 60-65%
LA:3.7
LVEDD: 5.3
Moderate/Severe Regurgitation with posterior leaflet prolapse

11/2021 Echo:
EF : 65-70%
LA:4
LVEDD:5
Severe Regurgitation ,
Anterior leaflet prolapse, thickened leaflets

5/2022 Echo:
Dont have all the details but the dr said LV is dilated with severe regurgitation

6/2022 TEE:
EF: 65-70%
Severe Regurgitation with posterior leaflet prolapse , likely a fail segment
LV: Moderately dilated
LA: Moderately dilated

I started to have arythmias in oct 2021, (after a dinner) , the holter shows 6000 PVC
No AF

In the past :

in 2002-2003, I had arhytmias happening once a month , it was like : my heart rate goes up to 130 for a few mins and suddenly dropping to regular rate. At that time I visited a cardiologist, they put me on holter and stress test. They said everything is good. This artyhmia disapperad in 2006 or so ..

2010, My then primary care dr heard a murmur and asked me if I had any heart problems, I told him the arythmias that happened before. He didnt refer me to cardiologist.

Appreciate any tips suggestions

  1. Hi. Thank you for posting your post and your great questions. Sorry you are having to deal with this issue at such a young age. As I am sure you know, we cannot offer medical advice nor diagnosis over the Internet, for your own safety of course. Although, I do have some thoughts that may help you. My first thought is that, as you say (other than your recent diagnosis of high blood pressure) you are not yet experiencing symptoms. This is good news, as your doctors have diagnosed you with a valve problem BEFORE it has resulted in symptoms for you. My take here is that, by taking swift actions and getting this leaflet problem resolved sooner rather than later, may prevent further symptoms in the future. That said, I do think it may also be a great idea to schedule another appointment with your physician and post your questions to him, perhaps exactly as you posed them to us above. I am certain your doctor will be able to answer all of your questions. What do you think? John. heart-failure.net community moderator

    1. My cardiologist retired a few months ago. My new cardiologist directly referred me to surgeon after the TEE exam and didnt want to discuss, I requested an appointment with him and asked some of these questions/ I still want to hear real-life experiences from people with similar experience. Sorry I am bit cautious about any surgery because of 2 unnecessary surgeries I had in the past

      1. Thank you for the update. And no need to apologize. I hear you about being cautious about having surgery. I would definitely do the same. I do hope others in the community step forward with their real life experience and/or advice. In the meantime, it may still be a good idea to make an appointment with either your cardiologist or surgeon to address any concerns that you have. A good doctor should be more than willing to do that for you. Good luck. Wishing you all the best. John. heart-failure.net community moderator.


    2. I guess you are a doctor yourself and dont want your colleague criticized.


      I asked these questions to his office, his nurse returned my call and said he was referring to Left Atrium not Left ventrical, this was not true. And they didnt answer my other questions despite I followed up twice



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