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Mild heart abnormalities

Discussion in 'Autonomic, Cardiovascular, and Respiratory' started by taniaaust1, Jun 22, 2011.

  1. taniaaust1

    taniaaust1

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    I just got got a copy of my echocardiogram report which I'd been previously told was normal .. on reading it thou I can see it is actually showing some mild abnormalities on it. Im assuming these are due to the ME/CFS?.

    It says I have "minimal mitral regurgitation" (mitral regurgitation is a abnormality found in 2% of general population) and "mild tricuspid regurgitation" (triscuspid regurgitation found in 1% of general population).

    On researching I found that half of cases of mitral regurgiation are caused by Mitral valve prolapse (MVP) which I know Dr Cheney has said is very common in ME/CFS patients. I cant remember what percentage of ME/CFS patients he said have that but I do remember it was very high.

    I went throu the causes of tricuspid regurgitation and the only one there seems to be a possible connection with me to (as the other things on the cause list I know I dont have eg lupus, carciniod tumors etc, connective tissue diseases such as Marfan syndrome) is "myxomatous degeneration".
    " Myxomatous degeneration is a term most often used in the context of mitral valve prolsapse which is a "primary form of myxomatous degeneration of the mitral valve". So im now thinking that the two leaky valves must have the same cause, that being MVP.

    Ive never had one of those tests Dr Cheney recommends for for MVP so dont know if I do have it or not.. so now just assuming that I do.

    Its all a bit concerning when I read http://en.wikipedia.org/wiki/Mitral_regurgitation and in it it says "Effect of diastolic blood pressure

    A change in the severity of mitral regurgitation may be associated with a change in diastolic pressure. In a study of people with heart valve regurgitation that compared measurements 2 weeks apart for each person, there was an increased severity of mitral regurgitation when diastolic blood pressure increased, whereas when diastolic blood pressure decreased, there was a decreased severity."

    My own diastolic pressure is usually around 90-100 (when awake.. and sitting which I do most of the time) thou it gets up to nearly 140 for diastolic at times when Im standing or moving about upright (of cause they stupidly never take it when Im upright to see this for themselves so are ignoring it). As I was certainly not standing up during that echo (I think it was done laying down?), I know my BP would of been at one of its down points when they did that echo, so possibly the mitral regurgitation issue was at its best when they were observing it.

    Makes me think what on earth is happening in my heart with this heart valve regurgitation which is only showing up very minor but I wonder now.. what on earth is happening when my diastolic is sky rocketing. Could this one day send me into severe heart failure? Could I actually be getting quite severe mitral valve regurgitation which they missed due to my orthostatic changes??? (of cause doctors arent worried per normal as they dont understand it all as that report came back currently showing only mild abnormalities, they arent worried .. but from what I just read at wiki it seems to be an issue which can really be varying with BP).

    A Hyde statement on ME which describes exactly what my body does Some seem to be unable to adjust blood pressure with body activity, resulting in high blood pressure on modest activity and very low pressure when reclining. (my diastolic can go down to 60 when laying)



    .............

    some quotes on ME and MPV and heart stuff (i havent found anything yet on the two issues they just found I have showing up).

    "Cheney reports that echocardiograms (sonograms of the heart) indicate that as many as 99% of his ME/CFS patients test positive for some level of diastolic dysfunction."

    (in my echo reports conclusion.. they just go "normal systolic function" and "minor aortic schlerosis" (I think that is hardening of the arteries).
    the diastolic isnt mentioned in the heart report.

    "There are two types of heart failure: systolic (which is a failure to eject) and diastolic (which is not a failure to eject, but a failure to fill properly). Diastolic heart failure was first described in the 1980s but there was no significant literature until the 1990s, and no significant way to measure it until 2001.

    Whilst there has been little recognition of the existence of diastolic dysfunction by some cardiologists (considered a relative rarity in 1986), in 2006 an article entitled Diastolic heart failure a common and lethal condition by any name was published by Gerard Aurigemma"
    ......................

    I guess those leaky heart valves would be counted as something which hinders hearts ability to fill????? so the mild issues I have if they worsen would lead to a diastolic heart failure?? (Im currently struggling to absorb the research im trying to do).

    "The fifth affected system is the heart: Cheney posits that the effect of compromised microcirculation upon the heart has an a part and a b part: part a is the manifestation of microcirculation impairment and part b is the event horizon.





    Part a: manifestation of microcirculation impairment: the initial manifestation of microcirculatory impairment of the heart is arrhythmia with exercise intolerance: when the patient goes upstairs, more cardiac output is needed but the patient cannot sustain it. As it gets worse, there will be mitral valve prolapse (MVP) because of inadequate capillary function. Finally, when there are even more severe microcirculatory problems, the patient starts to get chest pain as the myocardial cells die because they cannot get adequate oxygen.





    Part b: the event horizon: (once this line is passed, there is no going back): Cheneys view is that the event horizon with respect to the heart is this: when the microcirculation defect within the heart itself begins to impact Q itself, a vicious circle begins microcirculation impairment reduces the Q, which produces more microcirculation impairment, which produces even more Q problems, so down goes the patient into the next phase of cardiac failure, which is the lung.



    The sixth affected system is the lung and kidney: cardiac failure in the lung produces congestive heart failure (CHF) and pulmonary oedema, then the kidney is affected (the kidney is the last to go because it has the RAS back-up system). Combined with liver impairment, this stage is known as hepatorenal failure, which is the requisite cause of death due to Compensated Idiopathic Cardiomyopathy."

    I guess i have part a of the 5th system now going down? hence now these mild abnormalities showing in my heart. (I havent had my lungs or kidneys affected yet but have progressed throu all the other ME steps cheney talks about). http://hoopermedical.intodit.com/page/documented-cardiovascular-abnormalities-in-me-cfs in the 2005 section.
    .........

    Anyone got anything to add to my thoughts or know of info on the two issues my tests have showed and ME?
     
  2. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Hi Tania,

    Many of us have similar echo readings--mine are the same as yours. It is a very common finding among ME/CFS patients and while there are genetic issues at play, there are also other issues related to ME/CFS. Hydration can make a difference too (blood volume).

    Diastolic dysfunction sounds scary but also seems to be very common among our group as Drs. Cheney and De Meirleir tell us. Dr. De Meirleir did say that I had diastolic dysfunction when I showed him not only my echos but a whole folder of heart tests (both Cheney and De Meirleir are cardiologists).

    I think you mean systolic rather than diastolic when you quote your blood pressure readings above, but I think only a very clued-in doctor can really diagnose diastolic dysfunction--and it is reversible.

    One thing that makes some of us more prone to heart valve issues is Ehlers-Danlos Syndrome (usually the mild type 3 or hypermobility syndrome). It affects connective tissue and heart and vein valves are connective tissue. I have this and a good per cent of ME/CFS patients do too.

    Drs. De Meirleir and Cheney seem to want to treat the ME/CFS issues rather than directly treating heart issues. Hopefully this will resolve as we improve.

    I think mainly I want to say, don't be overly alarmed as we already know we are sick!--and this is one of the many complex aspects of the sickness that is common and doesn't usually lead to serious functional, heart problems. Still, as you well know, we have to listen to our bodies (and hearts!) and not overdo which can aggravate our situation.

    Best wishes,
    Sushi
     
  3. taniaaust1

    taniaaust1

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    Thanks for your reply Sushi. ah I didnt know that Dr De Meireir is a heart specialist. He very occassionally comes to Australia (every few years) so I'll keep an eye out for him and try to fly interstate to see him next time he's over here. Thank you.

    Nope.. it is my diastolic (the lower reading) not my systolic I was quoting.. my systolic is like 156 at times when my diastolic is 137 (and probably going higher as I dont take my BP much at all to see.. but it seems that my diastolic consistantly (once a day) seems to hit around 137 .. 138 at times). It concerns me this is being ignored as its fine when sitting and laying.. just an issue when Im standing and on my feet.

    Ive spoken to two people whos BP was doing the same as mine is.. and they both developed serious heart problems (were in heart failure), one of those was only in his 40s due to it and the other wasnt old either. (neither of those people had ME/CFS just had the same BP issue going on)

    My daughter (she hasnt got ME/CFS) I believe has Ehlers Danlos syndrome. I thou dont. I do think there must be a genetic connection between EDS and ME.
     
  4. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Hi Tania, Yes, the diastolic "shouldn't do that!" My autonomic specialist said that his diastolic sometimes went over his systolic too.

    I say this ought to be checked further. If you consider De Meirleir, he probably has a waiting list in Aust, (he has in Belgium).

    You could have the genetics of ED without the usual symptoms. This could be related to heart valves. The symptoms vary a lot.

    Hope you get good help with this.

    Best wishes,
    Sushi
     
  5. TinyT

    TinyT Senior Member

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    Hey Tania,

    Sounds like you really need a cardio that will do some orthostatic tests, even just measuring your BP/HR in sitting/lying and then standing.

    Sounds like you also need something like a stress echo (instead of just a lying down echo) to show these abnormalities.

    I also have 'trival' tricuspid valve regurgitation, physiological regurgitation in my pulmonary artery and have a 'mildly dilated left atrium'. The cardio (who was a jerk and didn't know anything about POTS) said this was normal. I take it that most cardios are used to seeing WAAAY abnormal hearts. Also, the equipment that they use is pretty sensitive and will pick up very small abnormalities.

    I do wonder though, what a ME/CFS cardio like Prof De Merlier would make of my heart findings......
     
  6. Tulip

    Tulip Guest

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    I got my results from my echo today and I too have mild mitral regurgitation plus oedema. My gp said that the mitral regurgitation needs to be watched closely and monitored because it can become chronic and lead to heart failure if left unmonitored, which is Cheney's theory isn't it?. Tried to tell my gp that this goes hand in hand with M.E. but she didn't get it.

    So make sure everyone with this prob (which it seems is all of us) to get it checked every 6-12 months (through an echo I assume?).
     
  7. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Hi Tulip,

    I had my "mild mitral and tricuspid valve prolapses with minor regurgitation" monitored every year by echo or stress echo and the findings never changed. I am no doing yearly checks now due to expense and the fact that they never changed.

    Sushi
     

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