cardiology/mitral valve prolapse questions
May 24, 2010 9:07 AM   Subscribe

Recently was hospitalized for acute bacterial endocarditis. The follow-up cardiologist visit is summed up as follows; "..had his echo/doppler study performed today. It shows mitral valve prolapse, which is quite severe. There is a suggestion of ruptured chordae involving the posterier leaflet. There is thickening of the posterier leaflet and a very severe mitral regurgitation. His left ventricular systolic function remains normal and his left atrial dimension is only mildly dilated. At this point, we are going to manage him medically and further management will depend on his progress". There is no medication yet, and I am due for a follow-up visit soon. Have been researching; and also want to ask advice of hive, for areas/questions to prepare. Subjects include his mention of future possible replacement; exercise and diet for heart health; anxiety related to MVP. Help me focus on a valuable discussion with the doctor.
posted by ebesan to Health & Fitness (5 answers total)
Make certain your mouth is very healthy, the bacteria that can colonize plaque on your teeth are known to cause endocarditis if they enter your blood stream (you will need to take antibiotics for dental visits the rest of your life).
One more reason to floss and see your dentist regularly.
Good luck in your recovery.
posted by OHenryPacey at 10:11 AM on May 24, 2010

I do not have knowledge related to your specific issue. However, when I have a doctor's appointment scheduled, I will try to keep a little notebook with me in the days or weeks ahead. Anytime I wonder something about whatever condition I'm going to the doctor for, I write it down. If it's something I can research myself, I do. If it's something I can't, I keep it to ask the doctor. At the appointment, I tell the doctor that at the end of our discussion, I'm going to ask her some questions that I brought with me.

I find that doing things this way means that I don't come back from my appointment kicking myself for not having asked something I meant to.
posted by ocherdraco at 10:13 AM on May 24, 2010

Best answer: IANAD(Y). In your situation, I would ask about timelines and contigencies. It sounds like you're doing okay now, but they expect that your heart might start functioning less than perfectly in the future. Find out how he/she will be monitoring your heart function over time, and find out at what point will you know whether something more than medication or monitoring will do. Find out what symptoms to watch out for on your end that might mean things are getting worse. If valve replacement is in the cards, (and it sounds like it might be) find out what kind of valve he/she prefers. There are benefits and drawbacks to both major kinds, mechanical and pig-derived, and it's good to have the information ahead of time so that you can think about it when things are relatively stable.

Best of luck!
posted by greatgefilte at 11:58 AM on May 24, 2010

(Oh, if you can track down a stethoscope, have a listen to your heart and see if you can pick out a murmur!)
posted by greatgefilte at 12:00 PM on May 24, 2010

Best answer: Been there. Done that. Now I'm part pig. As I understood it, there are four "Grades" of severity in Mitral Valve Prolapse, Grade 1 being mildest and Grade 4 being most severe. You have not stated your age or general health, so it is hard to relate directly. My murmur took nine years to get to the Grade 4 condition with little or no intervention. Waiting for Medicare made a huge difference in the ultimate out-of-pocket cost to me.

Questions I would ask include: What specific management plan do you have in mind for me? If it involves medication, does that come in generic form? What side-effects and life-style changes should I expect? How much time before surgery are we buying with this plan? Are there significant risks of enlarging the left ventricle because of the regurgitation? What is the risk of Atrial Fibrillation?

Now is a good time to study the differences between a mechanical valve (a lifetime of blood thinners) and a biological valve (10 to 15 year replacement period), the differences between "normal" open-heart surgery and "minimally invasive" surgery, and lifestyle changes that will help reduce the recovery time.

I love my pig valve and treat it once a week to a family reunion by having bacon with my breakfast. Best wishes.
posted by Old Geezer at 12:28 PM on May 24, 2010 [3 favorites]

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