Facing Mitral Valve Repair - Advice about Cardio

[scg]

I've been recently diagnosed with severe Mitral Valve Regurgitation I'm still an active biker and have 10 triathlons under my belt although not since 2009. My cardiologist who says I need repair...
I'm not happy with as he doesn't seem engaged when I see him. Twice he's recommended I go get a heart cath...not two weeks after I just had one by another cardio in his office.
I respect his knowledge, but I'm wondering whose advice is the most important... the cardiologist (I'm looking for another) or the cardiac surgeon? For the most part I'm asymptomatic, but
also recently diagnosed with HBP...probably due to the valve??...but do have palpitations occasionally. I'm 51 and trying to decide whether I should just go ahead and get this done or can I wait 6 months. Of course it might take 6 months just to see a couple of surgeons... Hoping to get back in time for the MS Bike tour in September, so I guess the sooner the better, but is that asking too much. So far I'm not too anxious about all this...yet. :rolleyes2:


EF 65% Prolapse of posterior leadflet, moderately severe MR primarily at P3.

 

[Rebecca]

Go to your family doctor and take a copy of your recent heart cat with you. Ask your family doctor for a name of a different cardio that is in a different cardio group because you want to get a second surgical opinion. Ask your family doctor if he had a family member that needed to see a cardio doctor who would they send them to? When you go for your second surgical opinion you need to take a copy of your heart cat. If they want to do another heart cat ask them why? Make a list of questions before each doctor visit. How soon to I need to have my valve repair? Is it still safe for me to exercise? Be sure to tell them how much you have exercise in the past and that you want to ride in the MS Bike tour in September. It is always best if they can repair the mitral valve.
I am four and half months out from having my aortic valve replaced and I am thriving.

 

[johnp]

My 2 cents. You will need to find a practice where the cardiologist, the surgeon and an electrophysiologist have a long working relationship, and are all engaged. There can be inter-related problems, before or after surgery. You do not want to be a ping pong ball. You will need to find a "light" or comical way to let your cardiologist know he is not giveing you a warm and fuzzy feeling about your case. Perhaps now is the time to broach the topic of your desire to consider "a state of the art medical center with demonstrated expertise is minimally invasive robotics, and an integrated approach..."


From my own experience, its nice to set you sights on some type of athletic event post surgery, but this will depend on your fitness level coming into surgery and the meds and heart remodeling that will need to take place after surgery. I was able to do 5 ks, and maybe a 10k 6 mos post surgery, and did log some bike rides up to about 30 miles, but my pace was much slower than in my days as a fanatic triathlete.

But you will almost certainly have some good days and bad days alonge the way. But you will get there.

 

[scg]

Both good advice. I just got back from my family doctor who is certainly more engaged...advised that I don't get rid of my cardiologist until I've talked to the 2 different surgeons that I have been referred to. If they say the same thing, then proceed with gut...if not, then go see a third who is best in the business in eastern north carolina. If surgeons say I can wait a while and observe, then look for new cardiologist, if not then deal with it when the time comes. I just rode my bike to the doctors office. Too nice a day to drive. I don't expect to compete in my age group again...I've had a 1st and 3rd place finish...but it would be nice to be riding into my 70's and perhaps longer. My 83 year old dad says that it was probably my training that messed up my valve...Thanks a lot dad.

 

[Adrienne]

Hi scg,

I just have one thing to say. I am sure that your training did not mess up your valve. If anything, it has kept you in good shape so that when you do finally have the operation, it will probably be easier for you to "get back on your feet".

 

[johnp]

[background music, Bruce Springsteen "Glory Days"]

My days of being one of the first 20 out of the water on certain races, or actually seeing the police car up ahead, while on the bike leg - those days are behind me forever.

But at least part of this is explained by the medications I am on now. The operation and meds have zero impact on my day to day, but I just don't have the ability to hammer it out anymore.

But if you have a leaky valve, and still try to push it, as I did, you end up with a very technically-worded echo that basically says your heart is compensating by dramatically increasing the size of your left atrium and left venticle. And man oh man, can that create problems!

 

[scg]

The last time I pushed it was in December sprinting up a hill against my 21 year old nephew who plays college lacrosse. I definitely maxed out the heart rate. It took me about 30 minutes to recover, but we completed 30miles and I was strong at the end leaving him in the dust. Since my diagnosis 3 weeks later, I have kept my rides easy and to 10 -15 miles. My nurse prior to my heart cath told me I had a "wicked murmur" and invited other nurses in to listen to it. I was never top 20 out of the water, but did well in my age group considering. It's when I turned 49 that he competition got more intense. I just want to be able to do a few 100 milers every year... maybe now at 17 instead of 20.