Symptoms related to mitral regurgitation and tricuspid regurgitation

Posted by jzarzeck @jzarzeck, May 30 9:54pm

Hello everyone, I went to the doctor originally on April 14th due to extreme fatigue, brain fog, dizziness and low blood pressure. I originally thought it was related to having COVID at the beginning of February. My PCP ordered a chest xray, blood tests and an echocardiogram. The xray and blood tests all came back normal. I had my echo done on Thursday. The results were sent me through "my chart" app from BJC Healthcare. I read the results which showed that I have both mitral regurgitation and tricuspid regurgitation. Where it stated I had tricuspid regurgitation it also mentioned "Cannot assess RVSP due to lack of sufficient TR jet." I am not sure if that meant they just couldn't see what they wanted to or if that means there was an issue. My PCP's office was only open until noon on Friday and when I called that morning they hadn't yet received the test results from the Hospital yet (normal for patients to get results first). Given the results I received would this be causing the fatigue and other symptoms I have been dealing with? On one of the days when I was at work dealing with the extreme fatigue I walked to the nurses office at work and my blood pressure was only 90/40. A couple of other times on days like this I also had low blood pressure (not as low as 90/40). I thought I had long covid but now I am not sure. The fatigue gets so bad that I fall asleep while driving in to work and once there I can't stay awake at my desk no matter how much coffee I have or how much I get up and walk around. I have had to leave work early 6 different days since mid February because I couldn't stay awake and didn't want someone to see me sleeping at my desk. On those days when I go home I sleep anywhere from 12-18 hours and still don't feel like I got enough rest. Anyone else experience these types of symptoms from Mitral regurgitation or tricuspid regurgitation? Thanks!

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Hello, I can see why you are concerned, especially if you were a busy, healthy person before Covid. And being unable to consult with your doctor undoubtedly made you worry even more. Sometimes I think it's a bad idea to post results to the patient portal before the doctor sees them and can explain.

Here are some things we do know:
The symptoms you were seeing in April, with the extreme fatigue, brain fog, etc are typical of long Covid. The initial tests all coming back "normal" is very usual after Covid.
We also know, from experience since 2020, that a Covid infection can cause changes in the heart due to inflammation. There is not a lot of study material yet to say whether those things heal or not.

Heart tests like the echocardiogram are just a starting point for the diagnostic process. Statements like "Cannot assess RVSP due to lack of sufficient TR jet." are very typical – it can depend on the skill of the tech, the sensitivity of the machine, the clarity of the image, the position of the patient…

When I had a stress echo last year, there were at least 4 statements like that in the report. I would have been alarmed, but the very comforting assistant in the room explained ahead of time not to be alarmed by any such statements. I also showed the regurgitations, but the cardiologist later explained they were mild, just to be watched, and not the true cause of my shortness of breath – and pointed me back to my pulmonologist.

At this point, I would suggest you take a deep breath, and wait to talk to your doctor. Given all the symptoms you are experiencing, maybe you would like to tak to them about getting into a long Covid program? Will you let me know what the doctor says?
Sue

REPLY

Hi @jzaizeck, I am so sorry to hear what you are going through. Please be careful, especially when driving. Is it possible for you to take leave from work or arrange to work from home? I think @sueinmn's suggestion to look into a long COVID program is a good one.
I was diagnosed with severe mitral valve prolapse with regurgitation in 2016. I went to the doctor for carpal tunnel syndrome, he heard a heart murmur and ordered an echocardiagram. I was monitored for three years. I had no symptoms, and was told to call the doctor immediately if I was short of breath. That never happened. I never felt tired. I kept working out hard (which my doctor was horrified to hear when I told him). The only thing different was an elevation of my blood pressure. I elected to have a mitral valve repair in 2019 because I would inevitably need one – the estimate was in three to four years. I was told surgical outcomes are better before the onset of congestive heart failure. I had some complications post surgery, recovered well, and last week the cardiologist told me my heart was great. I wish you the best and hope this helps.

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@sueinmn

Hello, I can see why you are concerned, especially if you were a busy, healthy person before Covid. And being unable to consult with your doctor undoubtedly made you worry even more. Sometimes I think it's a bad idea to post results to the patient portal before the doctor sees them and can explain.

Here are some things we do know:
The symptoms you were seeing in April, with the extreme fatigue, brain fog, etc are typical of long Covid. The initial tests all coming back "normal" is very usual after Covid.
We also know, from experience since 2020, that a Covid infection can cause changes in the heart due to inflammation. There is not a lot of study material yet to say whether those things heal or not.

Heart tests like the echocardiogram are just a starting point for the diagnostic process. Statements like "Cannot assess RVSP due to lack of sufficient TR jet." are very typical – it can depend on the skill of the tech, the sensitivity of the machine, the clarity of the image, the position of the patient…

When I had a stress echo last year, there were at least 4 statements like that in the report. I would have been alarmed, but the very comforting assistant in the room explained ahead of time not to be alarmed by any such statements. I also showed the regurgitations, but the cardiologist later explained they were mild, just to be watched, and not the true cause of my shortness of breath – and pointed me back to my pulmonologist.

At this point, I would suggest you take a deep breath, and wait to talk to your doctor. Given all the symptoms you are experiencing, maybe you would like to tak to them about getting into a long Covid program? Will you let me know what the doctor says?
Sue

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Thanks for the feedback! I originally thought it was long covid. I live near St. Louis and Washington University has a very good hospital. They have a long Covid research center there. I called to make an appointment in April before I got the echocardiogram and the first available appointment wasn't until Feb of 2023. I went ahead and took it and either hope to move up due to others cancelling because they no longer have symptoms or me cancelling for the same reason. My doc and I have talked about long covid a bit. Seems he wants to keep running tests for now before diagnosing me with it. He told me that if the echo came back without any concerns then we thought a sleep study would be the next step. He asked if I snored which I don't. He asked if my wife ever noticed that I stopped breathing while sleeping for a few seconds and she hasn't. I am ready to find out what is going on and I guess he wants to run tests ruling out the possibility for everything else. I don't know how sleep apnea effects the body but when I have the days where I feel fatigued it isn't like a normal tired. It's like I am shut down for the day and the next few as well. If I drank 5 pots of coffee it wouldn't make my symptoms go away. If I try to do anything physical at all it makes my symptoms even worse. I just don't know if sleep apnea effects the body that way or lowers the blood pressure on days where I am feeling the effects like I have noticed. I guess I will see what he says on Friday and go from there but at some point we are going to run out of tests to run and I guess at that point he will agree it's long covid?

Thanks for the feedback Teri and Sue!

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@jzarzeck

Thanks for the feedback! I originally thought it was long covid. I live near St. Louis and Washington University has a very good hospital. They have a long Covid research center there. I called to make an appointment in April before I got the echocardiogram and the first available appointment wasn't until Feb of 2023. I went ahead and took it and either hope to move up due to others cancelling because they no longer have symptoms or me cancelling for the same reason. My doc and I have talked about long covid a bit. Seems he wants to keep running tests for now before diagnosing me with it. He told me that if the echo came back without any concerns then we thought a sleep study would be the next step. He asked if I snored which I don't. He asked if my wife ever noticed that I stopped breathing while sleeping for a few seconds and she hasn't. I am ready to find out what is going on and I guess he wants to run tests ruling out the possibility for everything else. I don't know how sleep apnea effects the body but when I have the days where I feel fatigued it isn't like a normal tired. It's like I am shut down for the day and the next few as well. If I drank 5 pots of coffee it wouldn't make my symptoms go away. If I try to do anything physical at all it makes my symptoms even worse. I just don't know if sleep apnea effects the body that way or lowers the blood pressure on days where I am feeling the effects like I have noticed. I guess I will see what he says on Friday and go from there but at some point we are going to run out of tests to run and I guess at that point he will agree it's long covid?

Thanks for the feedback Teri and Sue!

Jump to this post

My daughter could have written "… but when I have the days where I feel fatigued it isn't like a normal tired. It's like I am shut down for the day and the next few as well. If I drank 5 pots of coffee it wouldn't make my symptoms go away. If I try to do anything physical at all it makes my symptoms even worse."
She suffers from long Covid, and it has taken her 2 years to learn to cope and manage her energy levels. She has been in a long Covid program for over half that time, and is getting better at knowing what she can do.
Have you seen the many helpful videos about post-Covid recovery on Mayo's blog?https://connect.mayoclinic.org/blog/post-covid-recovery/
It might help you to decide how far to go with other testing, and strategies you can try before you get in to see the long Covid clinic.
Sue

REPLY
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