Different Mitral Valve readings

[sharena]

I was diagnosed with mitral valve prolapse a few years ago and I have always had
about a 2.8 or 3 rergurg reading.

About 2 years ago I went to the local hospital to have an echo done and they said it was a 9.2. I was told not to move and I was scheduled to have an appointment in the city as I was most likely going to have open heart surgery. Needless to say I was traumatized. My friends urged me to have a second opionin. I did and once again my regurg was in the 3. range. I recently had another echo in my town and it read a 5. I have a new cardiologist and demanded a second opinion explaining my situation. He was startled when he found out I always have a 2 to a 3 and immediately I am set up for another echo in the city. Although I am fearful like last time I am refusing to stop my times at the gym and challking it up to another mistake with the machine.
  
I want to know if false readings happen often and why some hospitals seem to read different than others. I am aware that it can read SLIGHTLY different but to such an extreme I find it very alarming that this could be happening to a lot morer people.

[EchoTech]

To me it would seem that they are intermixing two different rating systems that are commonly used to rate mitral regurgitation (MR).  There is one system that uses a scale of 1 to 4+, one being much of nothing, and 4+ as being wide open backflow.  There is another system that measures the MR with  tracing the jet area that goes from  0( nothing) to 12+ (very severe).  Using the information that you gave, I would highly suspect that you have moderate MR.  It just appears that the different places use the different sysems.  One is not better than the other, it is ususally just what the cardiologists that read the studies prefer. This does raise some antennas on the cardiologists head, because it might mean that you need open heart surgery to either repair or replace the mitral valve.  However, you also state that you are going to the gym and exercising, which leads me to assume that you are not having any symptoms like getting out of breath real easy or getting tireed real easy or tired all the time.  
   The bottom line is that you most likely have moderate MR without  being symptomatic, which means you will probably get an echo every year until it is time to fix the valve.  The echos actually say the same thing, just in different ways, from what I can gather.  The valve might keep on like it is for a few years or a few decades, nobody really knows, hence the yearly check ups.  

Good night and good luck.

[Forum-M.D.-bkj]

Sharena,

We get a lot of questions about variability of echo readings.  Truth be told, echos have a subjective component with different readers interpreting a small amount of variability between the same echo. Add this to the fact that different institutions  
use different scales to grade echo findings and you can see why it's a common question.

Overall, I would try to consolidate your care with one cardiologist to minimize the variability.  

The biggest factor in determining when to replace/repair a mitral valve is the presence of symptoms or heart damage from the regurgitation.  There are some other factors, but overall I would follow up with one physician who should follow you with annual exams unless your symptoms were to change.

good luck