Heart Valve Insufficiency: Your Questions Answered

Heart valve insufficiency

Hello, I have been experiencing chest pain for almost two weeks.
I visited a large hospital and consulted a cardiologist, where I underwent X-rays, an electrocardiogram (ECG), and echocardiography.
The doctor concluded that there is a "valve" that is not closing properly, resulting in a slight regurgitation, but it is not significant, so it is not a concern.
I would like to ask if the "valve" refers only to the heart valves? I asked why there is regurgitation and why it is not closing properly, and he mentioned that it can happen to normal individuals.
Is that true? Furthermore, the doctor stated that my heart is fine, so the chest pain should not be related to cardiology.
I then consulted a pulmonologist, who said that all the reports looked healthy and suggested that I should see a cardiologist again.
Should I continue seeking further evaluation?
To summarize my questions:
1.
Is regurgitation a concern?
2.
Is it a problem if the valve is not closing properly?
3.
Which specialty should I consult next, or is further consultation unnecessary?
4.
A friend mentioned that if the valve continues to open, I might need a prosthetic valve in the future.
Is that true?
Thank you for your response, doctor.

Xiao Miao, 20~29 year old female. Ask Date: 2009/05/20

Dr. He Dongjin reply Cardiology

The veterinarian said that the "valve" is not properly closed, causing a slight regurgitation, but the amount is minimal, so it is not a concern.
The "valve" refers to the heart valve, specifically mitral valve prolapse accompanied by mild regurgitation, which is often caused by autonomic nervous system dysregulation.
Individuals with a sensitive personality are typical patients with mitral valve prolapse, also known as mitral valve prolapse syndrome.
About 5% of the population is affected by this condition, with a notably higher incidence in females, who are twice as likely to be affected as males.
The most prominent characteristics of these patients are being slender and tall.
If the connective tissue of the valve undergoes myxomatous degeneration during embryonic development, leading to elongated and lax valves, prolapse may occur later.
When the heart contracts, the elongated valve cannot close properly, resulting in blood regurgitating from the left ventricle into the left atrium.
In addition to the characteristic click of the prolapsed valve, a heart murmur may also be heard.
Patients with this abnormal constitution often experience a range of symptoms from head to toe, including dizziness, insomnia, palpitations, chest pain, panic, fatigue, chest tightness, generalized numbness, shortness of breath, and gastrointestinal discomfort.
These symptoms may be related to autonomic nervous system dysregulation, which involves either excessive or insufficient responses from the sympathetic or parasympathetic nervous systems.
Clinically, patients may present with various arrhythmias, including sinus tachycardia (the most common), bradycardia, ventricular tachycardia, atrial flutter, atrial fibrillation, or even cardiac arrest.
Although patients with mitral valve prolapse may seem to have widespread health issues, over 90% of cases are benign.
Aside from being somewhat anxious, they do not pose significant health risks.
Regular exercise, adequate rest, and occasional use of small doses of beta-blockers or sedatives can be beneficial.
Only a small percentage of patients (about 1%) may experience complications such as heart failure, endocarditis, arrhythmias, stroke, or sudden death.
Mild regurgitation and insufficiency can also occur in healthy individuals, and there is no need for concern about needing an artificial valve replacement.

Reply Date: 2009/05/20

More Info

Hello! It sounds like you have been experiencing some concerning symptoms related to your heart, and I appreciate your detailed description of your situation. Let's address your questions regarding heart valve insufficiency, particularly focusing on mitral valve regurgitation, which seems to be what you are referring to when you mention "the door not closing properly."
1. Is regurgitation a concern?
Mitral valve regurgitation occurs when the mitral valve does not close tightly, allowing blood to flow backward into the left atrium when the left ventricle contracts. The severity of regurgitation can vary. In many cases, mild regurgitation is common and may not cause significant health issues. However, it is essential to monitor the condition over time, as it can progress. Your doctor likely assessed the degree of regurgitation during your echocardiogram and determined that it was not severe enough to warrant immediate concern. Regular follow-ups are crucial to ensure that it does not worsen.

2. Is it okay if the "door" doesn't close properly?
As mentioned, mild mitral valve regurgitation is often benign and does not require treatment. However, if the regurgitation becomes moderate to severe, it can lead to symptoms such as shortness of breath, fatigue, or palpitations, and may require intervention, such as medication or surgery. It’s important to have regular check-ups to monitor the condition.

3. Which specialist should I consult?
Given your symptoms of chest pain and the findings from your tests, it would be wise to continue seeing a cardiologist. They specialize in heart conditions and can provide a comprehensive evaluation of your heart health. If your cardiologist has ruled out significant heart disease and you continue to experience chest pain, it may be worthwhile to explore other potential causes, such as gastrointestinal issues (like acid reflux) or anxiety, which can also manifest as chest discomfort.

4. Will I need a valve replacement in the future?
While it is true that some individuals with worsening mitral valve regurgitation may eventually require surgical intervention, this is not a certainty for everyone. Many people live with mild regurgitation without any need for surgery. The key is to have regular follow-ups with your cardiologist, who can monitor the condition and determine if and when intervention might be necessary.

In summary, while mild mitral valve regurgitation is common and often not a cause for concern, it is essential to stay vigilant and maintain regular follow-ups with your cardiologist. They can help you manage your symptoms and monitor any changes in your heart's condition. If you continue to experience chest pain or if your symptoms worsen, do not hesitate to seek medical attention. It's always better to err on the side of caution when it comes to heart health.
Additionally, lifestyle modifications such as maintaining a healthy diet, regular exercise, and managing stress can also contribute positively to your heart health. If you have any further questions or concerns, please feel free to ask. Your health and peace of mind are paramount!

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