Mild to Moderate Mitral Regurgitation: Key Insights for Patients

Please have the doctor review the heart report. Thank you?

1.
Echocardiogram BSA: 1.57 m² Sinus Rhythm
● M-mode Measurements: Ao Diameter: 24.8 mm, LA Diameter: 30.8 mm, LA/Ao: 1.24 IVSd: 7.8 mm, LVIDd: 50 mm, LVPWd: 8.3 mm IVSs: 9.2 mm, LVIDs: 35.3 mm, LVPWs: 11.6 mm EF (Qui, U): 50.2%, LV Mass (ASE): 136.89 g, LV Mass Index (ASE): 87.36 g/m²
● 2D Measurements: LVOT Diameter: 18.26 mm, LA Length A4C: 4.51 cm, LA Area A4C: 11.09 cm², LA Length A2C: 4.32 cm, LA Area A2C: 10.81 cm² LA Volume: 23.59 cm³, LA Volume Index: 15.05 cm³/m² LA Diameter A4C: 42.1 mm
● LVOT: LVOT Max Velocity: 1.06 m/s, LVOT Mean Velocity: 0.68 m/s, LVOT Max Pressure Gradient: 4.49 mmHg, LVOT Mean Pressure Gradient: 2.13 mmHg, LVOT VTI: 20.62 cm, HR: 69.14 BPM LV Stroke Volume (Doppler): 53.97 ml, LV Stroke Volume Index (Doppler): 34.44 ml/m² LV Cardiac Output (Doppler): 3.73 l/min, LV Cardiac Index (Doppler): 2.38 l/min/m²
● Aortic Valve: Normal Valve
● Mitral Valve: Normal Valve MV Pressure Half-Time: 43.2 ms Moderate Mitral Regurgitation Stage B MV E Velocity: 0.86 m/s, MV A Velocity: 0.62 m/s MV Deceleration Time: 148.97 ms, MV E/A Ratio: 1.39 S’ Septal: 7.01 cm/s, E’ Septal: 8.64 cm/s, A’ Septal: 7.28 cm/s, E/E’ Average (2016): 8 MV Pressure Half-Time: 43.2 ms, Mitral Valve Area by Pressure Half-Time: 5.09 cm² Pulmonary Vein S: 56.61 cm/s, Pulmonary Vein D: 50.33 cm/s, Pulmonary Vein A: 31.66 cm/s, E’ Lateral: 12.93 cm/s Diastolic Function: Normal, ASE 2016
● Tricuspid Valve: Normal Valve Mild Tricuspid Regurgitation at Risk Stage A TR Max Velocity: 1.27 m/s, TR Max Pressure Gradient: 6.45 mmHg IVC: 5-10 mmHg, RVSP: 16.45 mmHg
● Pulmonary Valve: Normal Valve PA Max Velocity: 1.2 m/s, PA Max Pressure Gradient: 5.76 mmHg PA Max Velocity: 1.2 m/s, PA Max Pressure Gradient: 5.76 mmHg
● LV Wall Motion: A= apical, B= basal, M= middle, a= anterior, i= inferior, l= lateral, s= septum 2015 ASE Basal = 1, Basal = 1, Basal Lateral = 1, Basal Inferior = 1, Basal Inferior = 1, Basal Septal = 1, Mid Anterior = 1, Mid = 1, Mid Lateral = 1, Mid Inferior = 1, Mid Inferior = 1, Mid Septal = 1, Apical Septal = 1, Apical Anterior = 1, Apical Lateral = 1, Apical Inferior = 1, Apical = 1, Wall Motion Score Index = 1
● Right Ventricle: TAPSE: 22.25 mm
● Summary: 1.
Left atrial enlargement.
2.
Preserved left ventricular systolic function, no regional wall motion abnormality.
3.
Preserved right ventricular systolic function.
4.
Normal diastolic function.
5.
Moderate MR, Mild TR.

2.
Doppler Color Flow Echocardiography BSA: 1.57 m² Sinus Rhythm
● M-mode Measurements: Ao Diameter: 24.8 mm, LA Diameter: 30.8 mm, LA/Ao: 1.24 IVSd: 7.8 mm, LVIDd: 50 mm, LVPWd: 8.3 mm IVSs: 9.2 mm, LVIDs: 35.3 mm, LVPWs: 11.6 mm EF (Qui, U): 50.2%, LV Mass (ASE): 136.89 g, LV Mass Index (ASE): 87.36 g/m²
● 2D Measurements: LVOT Diameter: 18.26 mm, LA Length A4C: 4.51 cm, LA Area A4C: 11.09 cm², LA Length A2C: 4.32 cm, LA Area A2C: 10.81 cm² LA Volume: 23.59 cm³, LA Volume Index: 15.05 cm³/m² LA Diameter A4C: 42.1 mm
● LVOT: LVOT Max Velocity: 1.06 m/s, LVOT Mean Velocity: 0.68 m/s, LVOT Max Pressure Gradient: 4.49 mmHg, LVOT Mean Pressure Gradient: 2.13 mmHg, LVOT VTI: 20.62 cm, HR: 69.14 BPM LV Stroke Volume (Doppler): 53.97 ml, LV Stroke Volume Index (Doppler): 34.44 ml/m² LV Cardiac Output (Doppler): 3.73 l/min, LV Cardiac Index (Doppler): 2.38 l/min/m²
● Aortic Valve: Normal Valve
● Mitral Valve: Normal Valve MV Pressure Half-Time: 43.2 ms Moderate Mitral Regurgitation Stage B MV E Velocity: 0.86 m/s, MV A Velocity: 0.62 m/s MV Deceleration Time: 148.97 ms, MV E/A Ratio: 1.39 S’ Septal: 7.01 cm/s, E’ Septal: 8.64 cm/s, A’ Septal: 7.28 cm/s, E/E’ Average (2016): 8 MV Pressure Half-Time: 43.2 ms, Mitral Valve Area by Pressure Half-Time: 5.09 cm² Pulmonary Vein S: 56.61 cm/s, Pulmonary Vein D: 50.33 cm/s, Pulmonary Vein A: 31.66 cm/s, E’ Lateral: 12.93 cm/s Diastolic Function: Normal, ASE 2016
● Tricuspid Valve: Normal Valve Mild Tricuspid Regurgitation at Risk Stage A TR Max Velocity: 1.27 m/s, TR Max Pressure Gradient: 6.45 mmHg IVC: 5-10 mmHg, RVSP: 16.45 mmHg
● Pulmonary Valve: Normal Valve PA Max Velocity: 1.2 m/s, PA Max Pressure Gradient: 5.76 mmHg PA Max Velocity: 1.2 m/s, PA Max Pressure Gradient: 5.76 mmHg
● LV Wall Motion: A= apical, B= basal, M= middle, a= anterior, i= inferior, l= lateral, s= septum 2015 ASE Basal = 1, Basal = 1, Basal Lateral = 1, Basal Inferior = 1, Basal Inferior = 1, Basal Septal = 1, Mid Anterior = 1, Mid = 1, Mid Lateral = 1, Mid Inferior = 1, Mid Inferior = 1, Mid Septal = 1, Apical Septal = 1, Apical Anterior = 1, Apical Lateral = 1, Apical Inferior = 1, Apical = 1, Wall Motion Score Index = 1
● Right Ventricle: TAPSE: 22.25 mm
● Summary: 1.
Left atrial enlargement.
2.
Preserved left ventricular systolic function, no regional wall motion abnormality.
3.
Preserved right ventricular systolic function.
4.
Normal diastolic function.
5.
Moderate MR, Mild TR.

● I would like to ask the doctor if there are any other heart-related issues considering the mild to moderate mitral regurgitation.
I feel a bit nervous and anxious since it's the first time I've learned about a heart issue.
I wonder if this is serious, as I tend to experience palpitations and increased heart rate at night.
Are there any precautions I should take regarding the mitral regurgitation? I will be undergoing dental procedures such as tooth extraction/root canal treatment; should I inform my dentist about this? Thank you for your help.

Miss Zhan, 30~39 year old female. Ask Date: 2023/03/14

Dr. He Dongjin reply Cardiology

Hello, there are no major issues.
Mild to moderate mitral valve regurgitation is not serious, so there's no need to worry about tooth extraction.
During root canal treatment, inform your dentist, and if you are concerned, you can ask them to use some prophylactic antibiotics.
There are no specific precautions to take on a regular basis.
Take care, and this is from Changhua Hospital.

Reply Date: 2023/03/14

More Info

Mild to moderate mitral regurgitation (MR) is a condition where the mitral valve does not close tightly, allowing blood to flow backward into the left atrium when the left ventricle contracts. This can lead to various symptoms and complications, and understanding the implications of this condition is crucial for managing your health.

Key Insights for Patients
1. Understanding Mitral Regurgitation:
- Causes: MR can be caused by various factors, including degenerative valve disease, rheumatic heart disease, or ischemic heart disease. In some cases, it may be associated with other heart conditions such as left atrial enlargement or heart failure.

- Symptoms: Many patients with mild to moderate MR may not experience significant symptoms. However, some may report palpitations, fatigue, shortness of breath, or even heart murmurs detected during a physical exam.

2. Echocardiogram Findings:
- Your echocardiogram results indicate left atrial enlargement and preserved left ventricular function, which is a positive sign. The left ventricular ejection fraction (EF) of 50.2% suggests that your heart is still pumping adequately, although it is on the lower end of normal. Regular monitoring of these parameters is essential to assess any changes over time.

3. Management and Monitoring:
- Regular Follow-ups: It is important to have regular follow-ups with your cardiologist to monitor the progression of MR and any associated symptoms. This may include periodic echocardiograms to evaluate the size of the left atrium and the function of the left ventricle.

- Lifestyle Modifications: Maintaining a heart-healthy lifestyle is crucial. This includes a balanced diet, regular exercise, managing stress, and avoiding smoking and excessive alcohol consumption.

4. Symptoms to Watch For:
- While mild to moderate MR may not cause significant issues, you should be vigilant for any worsening symptoms such as increased shortness of breath, fatigue, or swelling in the legs. If you experience these, it is important to consult your healthcare provider.

5. Dental Procedures:
- Regarding your upcoming dental procedures (tooth extraction or root canal treatment), it is essential to inform your dentist about your mitral regurgitation. Patients with MR may be at risk for infective endocarditis, an infection of the heart lining, especially during dental procedures. Your dentist may recommend prophylactic antibiotics before certain procedures to reduce this risk.

6. Anxiety and Emotional Health:
- It is natural to feel anxious upon learning about a heart condition. Consider discussing your feelings with your healthcare provider, who may recommend strategies to manage anxiety, including counseling or support groups.

7. When to Seek Immediate Care:
- If you experience severe chest pain, sudden shortness of breath, or fainting, seek emergency medical attention immediately, as these could be signs of a more serious condition.

Conclusion
Mild to moderate mitral regurgitation is a manageable condition, especially with regular monitoring and appropriate lifestyle choices. While it is important to be aware of your heart health, maintaining a positive outlook and staying informed can help you manage your condition effectively. Always communicate openly with your healthcare providers about any changes in your symptoms or concerns you may have.

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