Leaky valves

[ilovetheusa]

I recently underwent a 2d and Doppler Echocardiogram, and received the following report.

Quality - Study was technically adequate, however with poor subcostal views.

Left Ventricle - Pattern indicates impaired relaxation

Aortic Valve - possibly bicuspid, with doming noted.

Mitral Valve - Trace/mild (physiologic) regurgitation

Tricuspid valve - Trace tricuspid regurgitation present

Pulmonic Valve - appears structurally normal, physiologic degree of pulmonic regurgitation

All other parts of the test appear normal.

My question!, is it normal to have 3 out of the 4 valves to have regurgitation?

I was told I needed a valve replacement, before the test, because of severe shortness of breath and very little energy.  I take all sorts of medication for these problems, but I still have the problems
After the test I was told I did not need surgery but they will do another echo every year or so.

I also have angina, on exertion, but not severe enough to fix.

[ilovetheusa]

5 years ago, after a heart cath, they told me all my arteries were 50% blocked, but would not do anything until they reach 75% blockage.

I did just have a cardiac stress test, and it was 'negative test on medication', but stopped because of shortness of breath and fatigue after only 4 minutes, but I reached 98% of the target heart rate for my age..

[Flycaster305]

Have you had a cardiac stress test?  An echo doesn't address the possibility of a blockage of your arteries.  I'd ask for one before getting a second echo.  From experience with both valve and blockages, I'd think you should have both as well if possible, a heart cath.  Keep us informed.

[ed34]

No, if all valves in a heart have trace/mild regurgitation then it's fine. So, the aortic valve is not leaking, they feel sure about that much. So this leaves the pulmonary valve. This is obviously where blood exits the heart to travel through the lungs to receive new oxygen (right side of the heart). I would establish exactly what physiologic degree of pulmonic regurgitation means because I have no idea?

[ilovetheusa]

Thanks for the quick reply...Ed
I only included what I thought were the importants parts of the echo results, in order to keep it short.

The full report for the Aortic Valve is as follows - The aortic valve was poorly visualized, and the number of leaflets could not be determined - possibly bicuspid, with doming noted.  No aortic stenosis or regurgitation.

I am 72 and have shortness of breath, total lack of energy, pitting edema in both legs and both feet, as well as angina.

I also though it was rather inconclusive, so I'm going back to the internist in a few weeks, and will raise some of these questions.

I realize the regurgitation is minor in the valves, but considering it is hapening in 3 out of the 4 valves, can it have a accumulative effect?

Thanks for your help.

[ed34]

Well you can rule out your Mitral and Tricuspid valves, trace/mild is certainly nothing to be concerned about and will not affect your health. What concerns me is the aortic valve more than anything. I don't know your age, but I am guessing you are in or nearing your 50's or 60's if you have shortness of breath with the valve on exertion, which is the most common. The problem I have with the report is the absolute inconclusiveness of it. They state 'possibly bicuspid' and don't state if regurgitation is present in that valve, but they note 'domed'. If the valve is bicuspid (meaning you was born with 2 leaflets in the valve instead of 3), then they should be considering surgery sooner rather than later. If it is bicuspid and leaking, then you have a 25% chance of death in the next 5 years, a 50% chance in the next 10 years. Either they need to do an echo again, or another form of scan to establish the extent of the problem. To simply look at you once a year is not good enough in my book because they don't have the facts and without facts you certainly can't give a diagnosis and you certainly can't give the most appropriate plan. I would get a second opinion so the facts can be established.