Join Drs. Mustafa Ahmed and Alain Bouchard as they discuss Mitral Regurgitation — also known as ‘the leaky valve.’
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Hi Dr Ahmed,
I had a murmur reported in early 2019 at a job medical. I saw a cardiologist and had ECO performed showing Mild to Moderate Regurgitation with Posterior MV leaflet prolapse. LVEF 64% with normal LV Systolic Function. Doctor said no need for concern and to watch and wait with 6 monthly ECO’s. Could be years before surgery could be required he said.
However in January 2020 I had Mitral Valve (MV) Leaflet chordal rupture after exhaustion at work. I Felt the failure, this happened on the 11/01/2020. (January 2020). I called cardiologist that day and was told to book appointment to see GP. My normal GP was on leave so I saw another GP in same practice. She rule out heart issues and said I had phenomena. To shorten the story my Symptoms got worse and finally I saw my GP on the 6/02/2020 (February).
He agreed it was my MV and arranged urgent ECO with my cardiologist which found the following:
Severe eccentric MV Regurgiation with Posterior MV leaflet prolapse with leaflet failure. LVEF 65%. I was sent to have open heart surgery to repair the MV. Was successful and I’ve been done well.
Note: I was 45yo.
Some background to this story; In 2014 I was diagnosed and had treatment for APML leukaemia (treatments ATRA and ATO) “NO radiation”!
I was 39yo at the time of diagnosis.
Diagnosed on 14/05/2014 and had Pre-Treatment ECO (baseline) on the 16/05/2014; as early treatment issues (Rare) of differential syndrome (DS) caused by treatment can cause lung issues, Heart LV Systolic Function issues with reduced LVEF% and kidney failure in the worst cases.
The baseline ECO taken on the 16/05/2014 before treatment showed the following:
LV: Normal LV size and systolic function, EF61%
MV: Systolic buckling of the posterior mitral valve leaflet. Mild to Moderate MV regurgitation.
Treatment was stopped when I developed severe DS. Renal failure, heart failure and lung issues.
An ECO was done on the 12/06/2014 which showed the following:
LV: Normal LV size with moderately reduced Systolic function. EF42%.
MV: (No change). Mild MV regurgitation.
In the next few weeks/ months, Several ECO’s followed showing fast recovery of LV systolic function back to normal 26/08/2014 LVEF of 52% and LVEF of 57% in November 2014.
So 2014 LVEF trends of: 61 (Baseline before treatment), 42 (Heart Failure), 46, 52 (Treatment restarted), 54 and 57%.
During this time the mitral valve never changed from the base line ECO before 2014 treatment up until 2020 with the cord ruptured.
No mention of concern was ever raised about the Mitral Valve. Only focus was on LV function and LVEF. Which even when treatment re commenced it has never, even to this day been abnormal. Was only below normal for less than a couple of months max.
My cardiologist didn’t have all these details (ECO’s at the time) I only just received on request of history as I have some other new issues now with AL Amyloidosis. However I told him about the issues I had in 2014. He didn’t think any cancer or treatments caused the MVR. He thought I likely had it for years before.
Seems he was right now having all these results.
My question for you Doctor, now knowing all ECO results the LVEF dropped and recovered during further treatment and the MV had regurgitation before treatment started and didn’t change during heart failure (Systolic function of LV) or since.
In your opinion is my mitral valve rupture due to heart stress and history of MVR and prolapse? Not APML leukaemia or the treatments of?
Kind Regards,
Dennis Page
Yea I now have plasma cell IgD Multiple Myeloma and also AL Amyloidosis with GI, gallbladder and liver involvement. Possibly slight Cardiac involvement. On DVD (Dara, Velcade and Dex) treatments and working well. Going for Stem Cell Transplant in a month.
It is probably more likely that there was a degenerative process of the valve rather than it be caused by another process.
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Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.