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Question:

Can you explain when to have surgery for mitral regurgitation?

I was informed by my doctor that echo dated 2012 show moderate mitral regurgitation with LVEF 55% and mild aortic, tricuspid and pulmonary regurgitation. At the present time, I noticed shortness of breath walking and going up steps, dizziness, chest and left arm pain, sometimes swelling in my ankle, and coughing at night. My doctor informed me not to worry. I am confused. Can you advise? Also I read in the Society for Cardiovascular Angiography and Interventions website surgery is recommended to treat the mitral valve if the ejection fraction drops below 65% or if the left ventricle is enlarged. Is this true?

submitted by Richard from Baltimore on 3/17/2014

Answer:

Atasu K. Nayak, MDby Texas Heart Institute cardiologist, Atasu Nayak, MD    

Thanks for the question. I do not know the cause of your mitral regurgitation. There are many causes of mitral regurgitation and treatment varies depending on etiology. Usually patients do not have significant cardiac symptoms due to moderate mitral regurgitation. Your cardiologist/primary care doctor needs to find out the causes of your symptoms. 

In mitral regurgitation, other echocardiography criteria for mitral valve repair includes a dilated left ventricle in addition to LV ejection fraction less than 55%. Please discuss with your cardiologist. Serial echocardiograms are an excellent means of monitoring mitral regurgitation and LV size.

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Updated March 2014
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