Ive been diagnosed with billowing...

Ive been diagnosed with billowing mitral valve after being sent to hospital due to chest pain, shortness of breath and constant fatigue. I had the echo ultra sound and day hospital where they put dye into your heart. my discharge letter says MV to be checked every 3-5 years. Should I be worried?

Dr. Lance Nicholas Forbat
Dr. Lance Nicholas Forbat Cardiologist, Internist Bristol
I agree however, if you are still breathless exercising and there is no other cause such as asthma or obesity, the cardiologist should put you through an exercise test and repeat the ECHO to see what happens when you have breathlessness. It could be due to more significant regurgitation, when the heart is under load and the valve ring distorts or the leaflets bow like a hammock and further apart. This results in a more severe leak and increases pressure in the lungs. The anatomy of the valve can be seen in more detail by a transopesophageal ECHO (TOE) which involves passing an endoscope with a miniturised ultrasound probe on the tip.

I assume that the diagnosis was mitral regurgitation (MR) due to prolapse of one of both mitral leaflets. Mitral valve normally allows only blood flow from left atrium (top heart chamber) to left ventricle (bottom heart chamber). Mitral valve prolapse occurs when one or both parts of the valve slips into the left atrium during systole (heart contraction). The significance of the prolapse depends on the degree of MR (=amount of blood that leaks back), severe MR may lead to heart failure, arrhythmias etc. In your case MR was probably judged not significant. It may remain so but in some people MR may deteriorate over the time and eventually require heart surgery with either mitral valve repair (preserving the valve) or replacement (with an artificial valve). The symptoms (breathlessness, tiredness etc) may appear relatively late in the course of the disease and it is therefore important to have mitral valve checked with echo in regular intervals as recommended.

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