what is mild tricuspid regurgitation,trace pulmonary valve insufficiency,atrial septrum is aneurysmal,?

Question

also patent foramen ovale is suspected.have chest pains,high blood pressure140/100 pulse 110-116 i have passed out twice in two years very tired alot not over weight.i am taking blood pressure med, 325mg aspirin a day and a beta-blocker(blood pressure)and hydrochlorot(diuretic) DR TELLS ME NOTHING TO WORRY ABOUT ,well im concerned because my gram died aneurysm in brain aunt has lot of problems w/heart her 2girls heart murmurs grandad died of something with his heart (idiopathic pulmonary embolism) or fibrosis of heart something like that,uncle and gram died from congestive heart failure my mom no problems dad has emphazema. will i suddenly die from CHF.i've read that CHF is from some underlying problem. im 36yrs old and have other health issues to name couple asthma,(from smoking) dr hears wheezing, i think its something else and fibromyalgia (im also on the pain patch fentanyl(50mg every 2 days) and had radiation treatment once. thanks very much in advance for all your help

Answer 1

minldan - Oh my, I'm sure Sandy A meant well but a lot of what she wrote is not quite correct, so DON'T PANIC! In truth, the echocardiographic findings that you mention are all fairly benign, but I will go through them one by one for you.

1) Mild tricuspid regurgitation - Regurgitation just means blood leaking backwards through a valve. Having read hundreds of echocardiograms, I can tell you that it is rare for an echo NOT to have some trace to mild regurgitation. Most valves do not form a 100% perfect seal, but that does not mean they are abnorma. The tricuspid valve separates the top and bottom chambers on the right side of your heart. The fact is that the VAST majority of people with mild tricuspid regurgitation will NEVER have any problems that require medication or surgery. I would not say "it isn't closing as it should" because that implies that the valve is abnormal which is not necessarily the case.

2) Trace pulmonary valve insufficiency - The pulmonary valve prevents blood from leaking back into your heart after it is pumped into the lungs. "Trace" means that the doctor was able to see the teeniest squirt of blood back through the valve. Again, this is NOT abnormal and I would NOT say that your valve "isn't working totally as it should" or that it "isn't closing as it should". Also, there IS some blackflow of blood through the valve (that's what insufficiency means) but again, it is so little that we don't even call it "mild".

3) Aneurysmal atrial septum - The atrial septum is the wall of tissue that separates the top left and right chambers of your heart. "Aneurysmal" means that the wall is a little floppy and bounces back and forth. It is not "weak" - it's more like there is extra material there, like a size 4 woman wearing a size 8 dress. Now DON'T PANIC. It sounds scary, but some people think that there MIGHT be an increased risk of strokes in people with aneurysmal atrial septums. The key word is MIGHT. Also, remember that being at INCREASED risk doesn't mean that you are at HIGH risk. If something increases your risk from 1 in a million to 2 in a million, for example, your risk is increased, but it's still 2 in a million! That is why cardiologists do not recommend doing anything drastic like surgery for this - the surgery would probably be riskier than not doing anything at all! Taking an aspirin a day is probably a reasonable thing to do but at this point, we don't recommend it for everyone with an aneurysmal atrial septum.

4) Patent foramen ovale - OK, this not a birth defect or anything. We all have a foramen ovale (small hole) between the top chambers of our hearts while we are in our mothers' bellies. This is necessary to allow our moms to oxygenate our blood since we can't breathe when we're in the womb. Most will close within the first month of life BUT up to 25% of us will have incomplete closure and we call this a patent foramen ovale. 25%!!! That means if you have 20 people in a room together, 4 or 5 of you will have a PFO! That's not so bad, right? Are we going to do surgery to close a hole on 25% of the population? Of course not! In a TINY fraction of people with a PFO, sometimes a blood clot can sneak through and cause a stroke. If someone has a stroke and we think this has happened, we put people on either a blood thinner or an aspirin. We are doing studies now to see if closing the hole NOT WITH SURGERY but with special catheters will reduce the risk of a second stroke compared with just medicines. Again, up to ONE QUARTER OF THE EARTH will have a PFO and almost all of them will go through life without a single problem related to it. Unless you've had an unexplained stroke, when we see a PFO, we don't really think twice about it.

OK, so that's out of the way. Aside from that stuff, Sandy A makes some good points about your long-term health risks. Your high blood pressure is MUCH more likely to cause problems than the PFO or the aneurysmal atrial septum, so you should be focused on that and not on your pretty unremarkable echo! You need to get that under better control which may mean higher doses of medicines or additional medicines. The higher your blood pressure, the higher your long-term risk of heart failure, strokes, kidney diseaes, and heart attacks. Again, DON'T PANIC! This doesn't need to be brought under control TODAY or THIS WEEK or THIS MONTH even. Your blood pressure isn't high to the point of being an emergency, but if left that high for years and years and years, you are more likely to develop the problems mentioned above.

That fact that your gram died of a brain aneurysm isn't really alarming, but it means your blood pressure needs to be well-controlled. I wouldn't worry about your cousins having murmurs, especially since your echo didn't show any real valve problems. If your granddad had idiopathic pulmonary fibrosis (there's really nothing called idiopathic pulmonary embolism) that doesn't increase your risk of heart disease - it's similar to cancer. Uncle and gram dying from congestive heart failure doesn't necessarily mean you are in great danger either unless they were younger than 55 when they developed heart problems. Still, it would suggest that you need to get your blood pressure under control. Emphysema is almost always related to smoking so as long as you don't smoke, that should not affect you.

Don't worry about what Sandy A is saying about your renal arteries. A very small minority of people with high blood pressure have renal artery stenosis and we don't look for it unless you have difficult to control high blood pressure. Right now, with only two blood pressure medicines, you still have a lot of room for improvement.

I know that's a lot of information, but I wanted to make sure that Sandy A doesn't scare you too much. See your doctor and make sure your blood pressure is brought under control. Don't freak out about the echo results, they are truly nothing that you should worry about. I know she means well, but cardiology nurses don't go through years of intense training in interpreting echocardiograms; cardiologists do. If you have any other questions, feel free to send me an email. Hope that helps. Good luck!

Answer 2

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Answer 3

The mild tricuspid regurgitation means there is a small amount of backflow of blood backwards through the valve, it isn't closing as it should, but it is not a major issue at this point. The trace pulmonary valve insufficiency means that the valve isn't working totally as it should, it isn't closing as it should, but there is no backflow of blood through it right now. The atrial septum being aneurysmal means that the wall between the 2 upper chambers of your heart, the atria, has a weakened area in it. This doesn't mean it will rupture, it just means they should monitor it closely. A suspected patent foramen ovale means they are thinking that you may have a hole that did not close properly after you were born. Usually in the atrial wall. Babies have this feature during development in the womb and it should close on it's own after birth. If you indeed have this, they may end up closing it surgically. The surgery has been done a lot and is quite successful. While your echocardiogram findings aren't life threatening in themselves, I am concerned about your family history and that blood pressure. I do hope you are seeing a cardiologist and if you are and he told you don't worry, get another cardiologist. Your blood pressure needs to better controlled and your meds may not be the optimal treatment for you. Having prolonged poorly controlled high blood pressure makes the heart get large and unable to pump effectively, causing the CHF. The other issue here is your poor kidneys. They take a beating from the high blood pressure and can begin to fail, especially if you develop CHF. There is no reason they can't try to get better control of your blood pressure. You need a more aggressive doc. You also need to keep prodding them or just get a different doc so you are cared for properly. Don't ever be afraid to speak up and tell them what you need and want. Don't sit back and take this as all you can do for now. I hope you are also watching your diet, low salt or no added salt, low fat, high fiber...very important. Sometimes with difficult to control high blood pressure, they need to take a look at the renal arteries ( the arteries that supply the oxygenated blood to the kidneys). Some people get a narrowing (stenosing) of these arteries which leads to high blood pressure. This is treated by stenting the arteries which opens them up and normal blood flow is re-established. Please get another opinion from a good cardiologist.

Answer 4

You already have received two very good answers to your questions. I just want to add a couple things.

1) Smoking tends to make Tricuspid regurg worse. This valve leaks on all people that smoke and many that don't. They measure the velocity of blood flow thru this valve and if they didn't mention pulmonary hypertension then your numbers are still within normal range.
2) Trace Pulmonic insufficiency is something that MOST normal people have and they commonly don't even comment on it because it is no big deal.
3) They could do either a TEE or agitated bubble test to confirm a Patent Foramen Ovale. It has been linked to strokes and migraines. However, they wont close a PFO unless you have stroked or have stroke symptoms. It is a simple 1 hour procedure done in the cath lab and you go home the next day.

Best of luck!

Answer 5

Trace Tricuspid Regurgitation

Answer 6

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RE:
what is mild tricuspid regurgitation,trace pulmonary valve insufficiency,atrial septrum is aneurysmal,?
also patent foramen ovale is suspected.have chest pains,high blood pressure140/100 pulse 110-116 i have passed out twice in two years very tired alot not over weight.i am taking blood pressure med, 325mg aspirin a day and a beta-blocker(blood pressure)and hydrochlorot(diuretic) DR TELLS ME NOTHING...

Answer 7

Mild Tricuspid Regurgitation

Answer 8

mild tricuspid regurgitationtrace pulmonary valve insufficiencyatrial septrum aneurysmal

Answer 9

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Answer 10

I was wondering much the same question