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1325952 tn?1274923917

Could valve regurgitation be caused by Pulmonary Hypertension or vice-versa?

I have a 16 yr old daughter with auto-immune thyroid disease and a rare form of arteritis called "Takayasu Arteritis" (also believed to be auto-immune related).  TA has been an extremely hard disease to manage. Her MRI's of the Aorta and its branches shows that she has Left-subclavian occlusion at 100% with collateral vessels that have resupplied blood to her left arm. She also has partially blocked right subclavian artery with bruits mostly over right side neck. Left side bruits is no longer heard. She does have reduced pulse mostly on left but some on right. Currently new symptoms have included dizziness, headaches, some eye pain occasionally.  Most recently she saw a vascular surgeon to see if her newest symptoms could be explained by MRI of the subclavian arteries and vessels that supply the brain. This doctor also did an echocardiogram to see for himself an aortic valve leak that was previously seen by another doctor. The Echo now shows two additional valve leaks. Doctor said she has Tricuspid regurgitation, Pulmonic Regurgitation, and the Aortic Regurgitation. He said all seem small.  The doctor did not see reason for her most recent symptoms. We have an appointment set for mid-June with a neurologist who she has never seen before, but I was wondering if these 3 valve leaks together could be causing Pulmonary Hyertension and if that could explain her symptoms.  Or do you know of any other possibilities?  The problem with this disease is that it really requires a team of doctors to manage it, but its so rare that there are few groups like that in the country and the  ones I found are on the other side of the country.  My daughter presently is on: Steroids, Methotrexate injections, azathiroprine, Humira injections, Levothyroxine, & numerous multi-vitamins, calcium, etc.   Her Sed-rate was going up for about 2 months but the most recent test shows it is down to 15 from 33. Her CRP was also up but is now down to 4.1.  Her WBC is also high at 12.1 everything else is normal, including her liver and kidney panels. Perhaps she needs a new MRI to access her aorta and pulmonary inflammation or scar-tissue? Her last one was Oct 2009.
3 Responses
434278 tn?1324706225
It's me again.  I know in my husband's case, the blood would leak back into the left ventrical from the leaky valve, thus causing the ventrical to have to make a big thrust to get the blood that was in ther out as well as the extra blood that had back washed.  Thus causeing the annuryism and high blood pressure.  
1325952 tn?1274923917
thank you for that.  my daughter's drs are said friday that they want to watch her aortic valve along with her aorta which is dilated due to her disease. TA has attacked her Aortic arch, and the descending aorta mostly, but some ascending aorta as well. so far nothing is seen in her abdominal aorta.  the tricuspid and pulmonary valve were checked again and said not to be anything to worry about. her blood pressure is good and they just tested her pulmonary pressure which they said is also good! :-)  so now we just need to continue to get control of the disease thru immune supressant meds.  
434278 tn?1324706225
Sounds to me like things are going well.  God is going to get you all through this.  Trust Him and watch Him work.  I just want to encourage you in the Lord.  Press closer to Him and He will get close to you.  He is a very present help in time of trouble.

God bless and keep you and your daughter.
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