Mitral Valve Prolapse: Conflicting Echo Results Explained

Different results?

Dear Doctor: Last year, I went to the hospital due to physical discomfort and underwent a cardiac ultrasound.
I visited the cardiology departments at Hsinchu Hospital and Veterans General Hospital, both of which reported only mild mitral valve prolapse.
The doctors indicated that I had no heart murmurs and no regurgitation.
However, this year I received a military service classification, and after a follow-up ultrasound conducted at Taoyuan Veterans Hospital, the report stated, "mild mitral valve prolapse with mild regurgitation and mild tricuspid valve prolapse with mild regurgitation; cardiac function is normal." As an athlete, this situation has been very distressing for me.
I have consulted with doctors multiple times and undergone several examinations, and they all assured me that normal training is fine.
But why has tricuspid valve prolapse and regurgitation suddenly appeared in the results? Previously, I was worried and asked my doctor, who reassured me that there was nothing to worry about.
Why do I get different results from different facilities? Which report should I trust, and how should I proceed?

try yīxià, 20~29 year old female. Ask Date: 2006/03/14

Dr. Zhuang Junbin reply Cardiology

1.
It is normal for healthy individuals to have mild tricuspid regurgitation, so most cases are considered normal.

2.
Individuals with mitral valve prolapse may also exhibit prolapse of the tricuspid valve; however, the presence or absence of prolapse is not significant, as it is merely a result observed on 2D echocardiography.
As long as the regurgitation does not reach moderate levels (20-40% backflow), there should not be any major issues.

3.
Patients with mitral valve prolapse may experience some arrhythmias, which can be further evaluated and assessed.
Dr.
Chuang Chun-Pin

Reply Date: 2006/03/14

More Info

Mitral Valve Prolapse (MVP) is a condition where the mitral valve does not close properly, which can lead to mitral regurgitation (MR). It is not uncommon for patients to receive varying interpretations of echocardiogram results, especially when multiple facilities are involved. This can be particularly confusing for patients, especially athletes like yourself who are concerned about their heart health and performance.

In your case, the initial echocardiograms indicated only mild mitral valve prolapse without any significant regurgitation or heart murmurs. However, the recent echocardiogram from Taoyuan Veterans Hospital noted mild mitral regurgitation and mild tricuspid regurgitation. This discrepancy can arise from several factors:
1. Variability in Interpretation: Different echocardiographers may have slightly different thresholds for what they consider "mild" or "trivial" regurgitation. The subjective nature of interpreting echocardiographic images can lead to variations in diagnosis.

2. Technical Factors: The quality of the echocardiogram can vary based on the equipment used and the skill of the technician performing the test. Factors such as patient positioning, breath-holding, and even the patient's body habitus can affect the quality of the images obtained.

3. Progression of Condition: While it is less common, it is possible for MVP and associated regurgitation to progress over time. If your condition has changed since your last echocardiogram, this could explain the new findings. Regular follow-up is essential for monitoring any changes in heart structure and function.

4. Physiological Factors: As an athlete, your heart may respond differently to physical stress compared to non-athletes. Intense training can sometimes lead to changes in heart structure and function, which may be reflected in echocardiographic findings.

Regarding your concerns about the newly reported tricuspid regurgitation and the mild mitral regurgitation, it is important to note that both conditions are often benign, especially when classified as "mild." Many individuals with mild regurgitation lead normal, active lives without any significant symptoms or complications.
Here are some recommendations on how to proceed:
- Consult Your Cardiologist: Discuss the findings with your cardiologist, who can provide clarity on the significance of the new results and whether any further evaluation or monitoring is necessary.

- Regular Monitoring: Given the changes in your echocardiogram results, it may be prudent to have regular follow-up echocardiograms to monitor your heart's condition over time.

- Symptom Awareness: Pay attention to any symptoms such as palpitations, shortness of breath, or chest pain. If you experience any concerning symptoms, seek medical attention promptly.

- Maintain an Active Lifestyle: Continue your training as advised by your physician. Regular exercise is beneficial for cardiovascular health, but ensure you are following any specific recommendations from your healthcare provider regarding intensity and duration.

- Educate Yourself: Understanding your condition can help alleviate anxiety. Consider discussing with your doctor the implications of MVP and regurgitation, and what lifestyle modifications, if any, might be beneficial.

In summary, while conflicting echocardiogram results can be frustrating, they are not uncommon. The key is to maintain open communication with your healthcare providers and ensure regular monitoring of your heart health. Your active lifestyle as an athlete should be supported, provided that your cardiologist agrees that it is safe for you to continue your training.

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