Mitral Regurgitation – Mild, Moderate Or Severe?

Tamara,

As background, I was diagnosed with a heart murmur during a routine physical in April 1999. After an echocardiogram, they told me I had a “moderate to severe” mitral valve prolapse. Prior to being diagnosed, I ran numerous marathons and never had, and still do not have, any symptoms.

Like yours, my doctor also suggested monitoring it which we did for the last ten years. Over time, my mitral valve prolapse category changed to “severe”. This past year, they recommended surgery to repair the valve which I am now scheduled for this coming week on 5/13/09. I am nervous about it but I have checked this out with several doctors and they all think proceeding wit the repair is the best for my situation.

I would recommend a couple things if you have not done so already. One is to obtain a copy of your echocardiogram and office visit reports from the doctor. While they can be technical and complicated to understand, I have found them to be helpful to better understand my valve disease and be able to ask more informed questions. Another recommendation would be to get a second opinion. For example, there are a lot of other factors than just the different categories or grades and too many to list in an e-mail. The second opinion really helps to better understand all the information for your particular situation.

I hope this helps and best of luck to you!

Dan

P.S. Adam, Thank you for the great website and book. They have been very helpful to me and my wife as we prepare for my upcoming sugery. Thank you! Dan

As Adam stated, the TEE test is the definitive test to determine the degree of your regurgitation. What Adam didn’t really mention is that the TEE is an ultrasound test like an echo cardiogram except they put you to sleep and drop the ultrasound generator down your Esophagus. It’s no big deal except you can expect to have a raspy throat for a couple of days. Is it necessary and bearable? Yes! Will you have an irritated throat/ Yes. Is it worth it? YES!

Hi, I was diagnosed with MVP at 12y/o. Never had any problems or symptoms until recently. In Feb. at a routine check-up my murmur sounded louder then usual and I was referred to a cardiologist. After echo, EKG and TEE he felt my regurgation was moderate to severve with atrial enlargement and recommened surgery within 6 mos. I saw a surgeon and he ran his own echo and MRI and determined that I had moderate regurgation. He didn’t feel surgery was warranted at this time. The whole experience has been extremelly frustrating. I now am waiting for another appt. with my cardiologist to see where we go from here.
My question to others, have you had a similar experience and do you have symtoms?
For the last 6-8 mos. I have had fatigue, some SOB with bending over and any increased activity that envoles moving my arms, like mopping.
Also, this is not everyday that I feel bad, I have learned what causes the sx and just modify my activities.
I would appreciated hearing from anyone with similiar symtoms or experience. Thank you! Sharon

Sharon, I was diagnosed with severe with no symptoms. I put off surgery despite recommendations that I should have right away. I kept thinking..I don’t have symptoms, so I can wait a little longer. The thing was, during this whole time I was always thinking about it and it weighed me emotionally. Low and behold within a few months of diagnosing, I started having symptoms. I had to take rests and a nap everyday and just felt tired all the time. I still refused to believe I was having symptoms and was in denial. My wife was the one that finally brought to my attentions how far my quality of life had decreased. Others see it much more than you. I am now 7 weeks post-op and have had a pretty good recovery, however I also now realize it will take sometime to be 100percent. The biggest change, the stress that has been lifted off my shoulders because I finally went ahead and had it done!!!

Hi, I was born with an unusual heart murmur that was not able to be diagnosed until I was in my late 30′s, when the echocardiogram became available and I was told I had MVP. Also told that there was no treatment and to just “live my life” as I did not have a diseased heart. Later, in my 40′s I developed more arrythmia symptoms that were managed by beta blockers. I had a full life. Fast forward to my 70th year. I had celebrated my 70th birthday by “flying” in a verticle wind tunnel (like skydiving), did parasailing a few months later, was building stone walls in my garden, and keeping up with my grandchildren. Gradually I noticed I needed a short nap more frequently, but did not think it more than normal aging. Last spring I asked for a repeat echocardiogram just because I wanted to know that my heart was still healthy. I was shocked to be told that my MVP had gone from moderate regurgitation to “significant” with a recommendation for followup with a TEEand that I was a candidate for Mitral Valve repair surgery “sooner rather than later” in order to be able to avoid MV replacement.
In doing my research, I read the recommendations of the American College of Cardiology for Mitral Valve Prolapse treatment, revised in 2006. They reported that MV repair has been shown to be so superior to replacement that they are urging cardiologists to recommend repair surgery when the regurgitation gets to “significant” and not wait for further worsening. And they recommended that cardiologists refer patients to centers of excellence in MV repair, who do a high volume of MV repair, and to a surgeon who is an expert in repair surgery, having done 100-200 surgeries with a committment to repair.
By the time I had my TEE 3 weeks later, my MVRegurg had worsened to severe and I was having lots of symptoms – chest pain, shortness of breath, fatigue, lack of mental clarity, swelling feet, etc. Second, third, and fourth opinions, lots of research, reading Adam’s book, were all helpful in educating me and preparing me for a very successful Mitral Valve repair last Sept 2008, minimally invasive, with the DaVinci robot assisted approach.
Learning about CoQ10 and heart supplementation thanks to Dr Stephen Sinatra’s website and books have been very helpful in preparing for surgery and in recovery.
Learn as much as you can, keep copies of your records (they get purged form hospital records every 7 years, I learned), be proactive, be aware that stable MVP can take a sudden turn for the worse, and that the options for treatment are improving rapidly. Mitral Valve Repair surgery was invented only 15 years ago, minimally invasive approaches are relatively new and improving all the time, the DaVinci robotic assisted approach for MV Repair was about 2 years old when I had it. Just 2 weeks ago the news reported enhanced optics for the robot – it is not only 3-D, but now HD also, so the surgeon’s view of the valve is greatly enhanced. Who knows, maybe in the future MV repair will be an OP procedure! HA!
I am very happy with my results so far. It does take awhile to totally heal. I pay a price when I overdo and don’t pace myself, and am enjoying more energy than I can remember having before. Also, I realize now that I had gradually been giving up interests and activities as I was compensating for the gradual decreasing functioning of my MV. I love that my brain is now functioning, and can see the difference of the past several years.
Winona

Hi! I was diagoniased with moderate mitral valve regurgitation in November 2007. I was doing a routine medical check-up for a visa I was applying for. and the doctor heard a murmer and referred me for an echocardiogram. I had no symptons and was shocked. The cardiologist advised a yearly check-up. In January 2010 I was told that it has progressed to severe but since I have no symptoms I do not require surgery yet. However my ankles and legs are swollen. I sometimes have a slight pain on my left shoulder at the base of my neck. Is this a sympton. Does anyone reading have the regurgitation progress so quickly? How long before they decide it is bad? Please respond.

I am 41 years old and was recently diagnosed with MVP with moderate regurgitation. The TEE confirms this diagnoses. My stress test shows that I did great. My doctor wants to do a follow up echocardiogram in 6 mos. However, I feel tired all the time and sometimes feel lightheaded. I realize that symptoms sometimes appear when regurgitation is severe. Does anyone with moderate regurgitation experience any symptoms? Any thoughts?

Hi…I was born with MVR and I’m 36 years old doing a lot of sports and still having it as mild MVR. My doctor said that it can continue like that for the rest of my life without any complications! is it true? or the condition will eventually deteriorate leading to an operation…

Hi Jack,

I think it all depends on what is causing your MVR. That would be a good question for your cardiologist. In my case, my MVR is caused by a birth defect on my Mitral Valve. I was probably mild for a long time, but sometime in the last few years it progressed to moderate without me even knowing I had a problem. If I were you, I would either get a second opinion or ask your cardiologist more questions. In either case, it would be helpful to keep an eye on it in the event that it does progress.

I am 27 years old and pregnant with my fourth child. I have been severely struggling to breathe now for about 8 weeks. Has lots of test all came back clear. My heart rate shoots up to 140 when i walk up the stairs and my oxygen levels drop to 92 95 is normal oxygen at the minute. I had an ecg and the doc said it was a bit fast so an echo was done and they said i had MILD MR. Doctor just mentioned it as i was leaving. She said my breathing was not normal for someone pregnant and MILD MR is not the cause of my breathing problems. I have all the simptoms of mitral regurgitation i cant exercise i get dizzy and am really tired. When i say i struggle to breath i mean i need to sit down to get my breath back sfter making a cup of tea. Does anyone have any advice as the doctors have NO IDEA what is wrong with me. They just tell me now i have to just rest but thats not a solution as i am concerned about my forthcoming c section in 11 weeks. I also have a 1,2 and 4 year old to look after.