My daughter (16) was told by a Dr that she had an opening click in her heartbeat, but no following murmur. .?

Question

He said it could be one of two possible things : Bicuspid Aortic Valve or Mitral Valve Prolapse and recommended we take her to a cardiologist in Lubbock.
Could anyone tell me more about these conditions and how serious they are?

Loving_Heart,
Are you saying she has tension that is causing this opening clicking?
She has not had a test yet. A Dr only listened to her heart and heard the clicking. He said there was NOT a murmur following the click. Is this normal to have a click and no following murmur? We have not seen the cardiologist yet.

Answer 1

An opening click is an unexpected noise that may be heard with a stethescope on patients with valvular abnormalities.

A BiCuspid Aortic Valve is congenital (from birth) in 1-2% of the population. The Aortic Valve normally has three panels that swing open when the ventricles (the lower heart chambers) contract. With BiCuspid AV, two of those panels (aka valve leaflets or flaps) are fused together, in effect, now rendering the valve to be a two panel valve instead of three. Of the people that have it, most don't even know about it and lead perfectly functional and unrestricted lives. Periodically, an astute clinician hears something on a routine exam and follows up further, allowing its discovery.

Problems can either be on opening or closing (that is, "stenosis" or not opening enough; versus "incompetence" or not closing fully).

Mitral Valve Prolapse is a problem with closure of the valve between the left upper and left lower chambers. Normally, just before the heart beats, the Mitral Valve stays open to allow blood to move from the left upper chamber into the left lower chamber of the heart. It is the intake valve of the left ventricle. When the heart beats, this valve is then supposed to close, allowing the contents of the left ventricle to be pushed out via the Aortic Valve (or outflow valve). With Mitral Valve Prolapse, a portion or all of a valve flap is pushed back into the left upper chamber, allowing some blood to backflow into the left atrium (instead of heading out the Aortic Valve). In serious cases, this will cause difficulty breathing, and or rapid heart palpitations. Again, most people who have this experience it only mildly and live normal lives.

Let the cardiologist examine her. I doubt that it will turn out to be anything of consequence as your daughter didn't present with shortness of breath or palpitations in an emergency room. Your doctor heard an errant sound that shouldn't be there, so he is doing the wise medical thing of examining further. I suspect that it would probably only result in it being monitored periodically and the routine taking of antibiotics before dental procedures.

If there were serious valvular problems, she would have already had multiple symptoms. In cases such as that, the treatment usually involves medications versus repair or replacement surgery.

Good luck ;)

Ralph

ADDENDUM: Just saw your additional question: Don't worry about the noises (murmurs, gallops, rubs, clicks, snaps), as they are ABSOLUTELY MEANINGLESS without clinical correlation; Look at the patient and how she's doing. I've seen some patients with murmurs so loud that they can blow your ears off (when you listen with a stethescope) literally just sit there with no problems at all; while another with a small barely detectable murmur is gasping for air with a heart beating out of her chest. Whether she has a murmur or not at this point is moot. See the cardiologist.

Answer 2

Just go to the Cardiologist, he can tell what's going on. That's why they get the big bucks. All the "Murmur" means is there are some noises associated with the pumping action of the heart. There are many possible causes.

Answer 3

Ma'am, did you accompany your daughter during the her visit FOR THE TEST. you see when in this age a slight touch of the chest can give rise to excitement, which will give rise in BP. This give rise to murmer also known as systolic murmur which is normal..
Have a echocardiogram, done immediately/earliest, it will rule out any disease of valve or murmer. She is experiencing tension.

Answer 4

go to webmd.com
very good website, with lots of usefull information. good luck to you and your daughter