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Just diagnosed with moderate mitral regurgitation
I am 72 years old, 6'2" and weigh 205 pounds. My resting heart rate is around 55 and I ride a bicycle rain or shine or heat from 1030 to 1230 every day.
As long as I can remember, I've had "palpitations", maybe a few in a year, but 3 weeks ago, beginning on Friday afternoon I started having a few over a 2 hour period, followed by a 3 hour pause. This continued over the weekend and Monday morning I went to a CareNow. They did a blood panel and ECG. The bloodwork showed nothing abnormal but the doctor said something about "bradycardia", but I've been riding a bicycle 100-150 miles a week for the last 15 years, so she said my heart rate is unlikely an issue.
I was told that I need to see a cardiologist. My PCP referred me and 2 days later I had another unremarkable ECG , and given a treadmill stress test that showed "early" beats, and I was given a Holter monitor to wear for 72 hours.
Three days later, I was given an echo-cardiogram, the following day I was given a nuclear stress test. Finally, 3 days later I was provided with the results. The cardiologist said the nuclear stress test showed no blockage but was only about 85% accurate, but the echo-cardiogram showed "moderate mitral backflow".
Right or wrong, the only reason I went to CareNow in the first place was because I was riding in a cycling endurance race (Hotter N Hell 100 in Wichita Falls. TX) and it seemed wise under the circumstances. He told me I was ok to ride but only give 70% and avoid pushing my heart rate over 150.
I asked, other than that, I am generally free to do what I want physically, and he said yes, but have another echocardiogram in 1 year and contact him immediately if "anything changes" or go to the emergency room if I need to.
I asked him what "moderate" meant and he said "I wouldn't worry about 'mild' and if it was 'severe' I would suggest more aggressive treatment, but your backflow is moderate." He didn't quantify "moderate".
I still feel a little in the dark, uncertain if I should be more concerned. He said "this is generally good news" but I don't feel that way.
Thanks in advance for any thoughts or observations.
Steve
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It is difficult to situate you, even with the information you provide. Statistically, in measurement of populations, moderate is the same as the range comprising all sets in 'average', so everything under a normal distribution, Bell curve, that fits between one standard deviation above and below the 'mean.' A percentage of regurgitation is what is normally given, even to the patients themselves. Or, what is more commonly called the 'ejection fraction', also expressed as a percentage.
If you held me down and wouldn't let me up until I gave my ignorant answer, it would be that your EF is not sufficiently dangerous that you're either symptomatic (because you've been exercising willy-nilly all this time without detriment that is noticeable to you) or it isn't apparently sufficiently extensive that you fit in the category where they would strongly urge you to have a valve repair. It's the same as having an obstructed artery. If one of your carotid or coronary arteries is only 50% occluded, they will do nothing except ask if you'd take a statin or change your diet, or submit to genetic testing to see if that's what's going on. But, when you get to 70%, they begin to press you to get in line for surgery or some other remedy that might be more suitable for you as an individual with certain needs and limitations. Empirically, with variation between individuals, much after 70% is when people become objectionably symptomatic or they appear in an ER in real danger....and then acting is of the utmost and critical importance.
You're not there......................................................................yet.
You are 72. No matter how well you have taken care of yourself, parts start wearing out, clogging and leaking
I was told for 40 years I had an athletic heart big ventricle 50 hr. Then suddenly the same condition was bradycardia needing lots of tests and meds. Does athletic heart turn into bradycardia?
You are doing great. Keep an eye on your ticker. The docs are good.
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3 ReactionsI was followed for 20 years starting at age 40 for mitral valve insufficiency, being told that I would someday require mitral valve repair. I went from a “mild” classification to “moderate” as I aged. A large part of deciding when to operate was how I felt ( breathlessness and fatigue when exercising?) along with results of the echo and ejection fraction. Walking uphill on a golf course created breathlessness. I was turning 60 and decided to have the repair at the doc’s suggestion. No point in waiting when increased age can create increased risk, both surgically and one’s heart health. Went to Cleveland Clinic in Ohio where I experienced excellence in every way. My repair still shows only trace regurgitation which is normal for everyone at my age-78.
Today, the repair is routinely done with a minimally invasive technique with a much quicker recovery. This is all to say not to be afraid if repair is necessary . Refusing surgery would have resulted in eventual heart failure because the heart has to work harder to compensate for the leakage. The compensation results in an enlarged and weakened heart which struggles to pump blood efficiently. This equals heart failure.
Keep a close eye on routine test results and how you are feeling.
Good luck!
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1 Reaction@gloaming Is there significance to your use of 70 periods between "there" and "yet"?
Steve
Just for effect.............................................to simulate a pause. Commas, semi-colons, they seem to have lost their effect in modern texting and posting. Or, so it seems to me.
I'm just super impressed with your apparent BMI, resting HR and the amount of exercise you do, HIIT or just Zone 2? On a side note, there's extensive peer-reviewed literature that HIIT, roughly 1x per week significantly impacts quality of life for seniors (>/= 65). On the "moderate" issue, I have personally seen that word used in my own case, one heart and one non-heart related, and when pressed the medicals tell me it means that treatment is largely patient driven, that is, if you push to get it taken care of, then it will happen. Otherwise, you fall into the "lets' keep an eye on it" category. Seems straightforward to me. Me? I would at least explore the "taken care of option" with a cardiac surgeon and learn what's involved, risks, and sequalae from the surgery. Not that I would opt for surgery, but I just want all the information I can get before making any decisions.
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1 Reaction@jmarsh 80% Zone 2, 15% HIIT, 5% Eating ice cream
When I am asked about "shortness of breath" after climbing stairs . . . who isn't at age 72? I recover pretty quickly. When my heart rate reaches 145 while cycling, I feel my pulse pound in my temples. As soon as I back off the pounding subsides. Does that pounding have anything to do with mitral regurgitation?
I failed to ask my cardiologist these questions, so I suppose I'll have to make an appointment to see him.
Steve