Heart Health: Key Questions About Mitral Valve and Medication

Follow-up on heart issues?

Hello Dr.
He, I am the patient with ID #135059.
Thank you for your response, which has reassured me a bit.
When I feel happy, I think everything is fine.
However, I would like to ask a few more detailed questions regarding some issues I previously overlooked.

To inform you of my condition, I have mild mitral regurgitation (the doctor said it’s nothing to worry about), an exercise ECG indicating mild myocardial ischemia, and an echocardiogram showing narrowing of a certain coronary artery (it should be 4 cm, but mine is only 2.92 cm).
I mentioned before that I am taking 5 mg of Rosuvastatin once a day, but I forgot to mention that I am also taking 25 mg of Sotalol once a day.
I need to wait three months before returning for blood tests.

I would like to ask a few questions:
1.
My blood pressure is usually on the low side.
What side effects can occur from long-term use of Sotalol?
2.
Can medication and increased hydration and exercise really improve vascular dilation? (Why did the doctor say to hope for dilation?) I don’t quite understand.

3.
I have autonomic nervous system dysregulation and tend to feel anxious and tense.
Currently, I am not taking any medication; I just remind myself to relax and breathe when I feel it.
Usually, it’s not severe and resolves quickly.
Do you recommend that I maintain this approach, or should I see a psychiatrist?
4.
Regarding the sublingual nitroglycerin tablets, I actually forgot where I put them.
When the doctor prescribed them, he said they were for emergencies (I understand the doctor’s caution), but it has increased my internal fear.
I tend to be anxious and overthink, and having this medication makes me wonder if my condition is serious enough to need it on hand, which makes me feel more uncomfortable.
I would like to understand correctly: based on the symptoms and conditions I have described, do I really need to carry it with me at all times, or is it not that serious?
I appreciate your kind response to these questions, Dr.
He.
Thank you!

Chen S, 30~39 year old female. Ask Date: 2018/04/25

Dr. He Dongjin reply Cardiology

Hello, you have mild mitral regurgitation - no need to worry about exercise electrocardiograms indicating mild myocardial ischemia - observe echocardiography to assess for coronary artery stenosis - theoretically, ultrasound cannot visualize coronary arteries.
Medication and increased water intake along with exercise may help improve vascular dilation - this could potentially reduce vascular spasms.

1.
Currently, Ranolazine may help alleviate vascular spasms; it is optional and not related to low blood pressure.

2.
I do not believe that medication and increased water intake along with exercise can significantly improve vascular dilation.

3.
Autonomic nervous system dysregulation can be addressed by consulting a psychosomatic specialist - I believe this is your primary concern.

4.
It is not that serious - just monitor your condition.
Changhua Hospital cares about you.

Reply Date: 2018/04/25

More Info

Hello! Thank you for reaching out with your questions regarding your heart health and the medications you are currently taking. It's great to hear that you are feeling more at ease after our previous conversation. Let's address your concerns one by one.

1. Long-term use of Soredit (Sotalol): Sotalol is a medication primarily used to treat certain types of irregular heartbeats (arrhythmias). While it can be effective, it may have side effects, especially with long-term use. Common side effects include fatigue, dizziness, and bradycardia (slow heart rate). Since you mentioned that your blood pressure tends to be low, it is important to monitor your heart rate and blood pressure regularly while on this medication. If you experience significant dizziness or fainting spells, you should consult your healthcare provider for further evaluation.

2. Medication, hydration, and exercise for vascular health: The use of medications like Soredit and statins (such as your Coronary Lipid medication) can help manage cholesterol levels and improve overall cardiovascular health. Drinking plenty of water and engaging in regular physical activity can also support vascular health. Exercise helps improve blood flow and can promote the dilation of blood vessels, which may alleviate some symptoms of ischemia. Your doctor likely mentioned the hope for vessel dilation because improved blood flow can enhance oxygen delivery to the heart muscle, potentially reducing symptoms of angina or ischemia.

3. Managing anxiety and autonomic nervous system dysregulation: It's good to hear that you are using breathing techniques to manage your anxiety. If your anxiety is mild and manageable, it may not require medication. However, if you find that it interferes with your daily life or becomes more severe, it might be beneficial to consult a mental health professional. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can be very effective for anxiety management.

4. Sublingual nitroglycerin (救命丹舌下錠): This medication is typically prescribed for the acute relief of angina (chest pain). While it can be helpful in emergencies, it is understandable that having it on hand may increase your anxiety. If your symptoms are infrequent and manageable, you may not need to carry it with you at all times. However, if you experience chest pain that is severe or does not resolve quickly, having the medication available can be crucial. It’s important to have a conversation with your doctor about your specific symptoms and whether you should keep the medication on hand.

In summary, it sounds like you are managing your condition well, but it’s essential to maintain open communication with your healthcare provider about your symptoms and any concerns regarding your medications. Regular follow-ups and monitoring will help ensure that your treatment plan remains effective and appropriate for your needs. If you have any further questions or need clarification on any points, don’t hesitate to reach out. Wishing you continued health and well-being!

Similar Q&A

Understanding Rytmonorm: Effects on Mitral Valve Issues and Heart Health

I have a problem with my mitral valve. I have been taking Rytmonorm for six months. Recently, my electrocardiograms have been normal, but I'm not sure if it's due to the medication. Another hospital mentioned that taking this medication might be too serious for me.

Dr. He Dongjin reply Cardiology
I am unclear why the mitral valve requires this medication. I believe the prescribing physician has their considerations. You may want to consult your original outpatient physician or seek further evaluation at another cardiology clinic. The information you provided is too limite...

Understanding Mitral Valve Prolapse: Symptoms, Medications, and Risks

First of all, thank you for your reply. I truly appreciate your willingness to help someone you have never met! The medications my friend is taking are Vetrimil 40mg and Erispan. She does not have mitral valve regurgitation or mitral valve thickening, but she experiences chest ti...

Dr. Li Dong'an reply Internal Medicine
Hello A-Liang, 1. Vetrimil is a calcium channel blocker, and possible side effects include bradycardia, hypotension, and constipation. Erispan is a sedative, and its potential side effects include drowsiness, which should be avoided by pregnant women. The occurrence of side effe...

Understanding Mitral Valve Insufficiency: When Is Surgery Necessary?

Hello, Doctor: If I remember correctly, when I was younger, I had a heart murmur and noted left ventricular hypertrophy during my annual employee health check-up. Since I had no symptoms or discomfort, I did not seek medical follow-up. About ten years ago, I was prescribed medic...

Dr. He Dongjin reply Cardiology
Hello, I suggest that you gather all your examination data and seek a second opinion from another physician. Personally, I hold a more reserved attitude and might consider it when there are active symptoms of wheezing. Changhua Hospital cares about you.

Understanding Mitral Valve Disease: Symptoms, Treatment, and Lifestyle Tips

Doctor: I have been experiencing sudden chest pain for a week, and I went to the Tri-Service General Hospital where I was diagnosed with mitral valve disease, specifically "secundum atrial septal defect." What is this condition? Do I need surgery or is medication suffic...

Dr. Zhong Yuxun reply Cardiology
Hello Duck Duck online friend, "Secundum atrial septal defect" is a type of congenital heart disease. You have already been evaluated at the Tri-Service General Hospital, and your questions should be directed to your attending physician, as they relate to your specifi...