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Question:

Do I have a serious valve condition that will require surgery? 

Hi, Doctor. I experienced tachycardia on Aug 29. I couldn’t get it down in an hour so I went to my GP who sent me for a 2-d echo. I have the results now and I’m quite worried. For my peace of mind, could you answer some questions that have been plaguing me?

The result shows a thickened and long anterior mitral valve leaflet with prolapse; short posterior mitral valve leaflet with low coaptation point. Thickened right aortic cusp and non-coronary cusp with calcifications without restriction of motion but with evidence of mild aortic regurgitation. I also have mild mitral, pulmonic and tricuspid regurgitation. In addition, my stroke volume is only 27cc/beat and cardiac output is 2.2L/min. Could this have been caused by beta-blockers I took before the procedure? I don’t have any symptoms other than the tachycardia which gets worse when I’m ovulating/menstruating and the occasional skipped beats. I am taking metoprolol for the tachycardia and vastarel for the ischemia detected on EKG.

Now, I’m only 25 y.o. Am I not too young to be having this although it is familial? How quickly does this progress? Is this deadly? Do I have to wait for it to become severe to go for surgery? Is there a way to repair my mitral and aortic valves? Is there a way to decalcify my valves? Is this something to be worried about? My BP, FBS and cholesterol levels are normal. Thank you for taking the time to read this. Although no one in my family afflicted with this died because of it, I still am scared out of my wits when I think about what could go wrong. Thank you.

Submitted by Mara from Philippines on 09/23/2013

Answer:
by Denton A. Cooley, MD

From your description, it doesn’t seem that you should consider surgery. Your doctor should direct trials of medication to control symptoms for the present. You may require surgery in 10 or more years, but meanwhile, medical management seems appropriate.