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Regurgitation vs Stenosis

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Jmprosser.lab

Well-known member
Joined
Feb 2, 2018
Messages
56
Location
Los Angeles, Columbus Oh
Recently had someone say to me: “Oh you have regurgitation and not stenosis, lucky you.”

First i had ever heard of those two being compared. Does anyone have any info or literature to share discussing the difference?
Is one really less severe than the other??
 

nobog

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Joined
Jun 14, 2019
Messages
92
Stenosis means stiff leaflets - stiff leaflets can cause regurgitation because they don't seal properly, however stenosis is typically associated with a higher pressure drop - there is a restriction. Regurgitation (flowing the "wrong way") can also be caused by a leaflet prolapse, a hole, or leaflets simply worn out. Some regurgitation is normal - to much puts a higher load on the heart as this fluid needs to be repumped for every beat.
 
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Superman

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Joined
Oct 3, 2009
Messages
959
Location
Grand Rapids, MI, USA
I know I had both growing up. As a kid, it was described as the valve doesn’t open all the way (stenosis) and it doesn’t close all the way (regurgitation). Not enough oxygen rich blood gets pumped out to the body because of the narrow opening. Of the blood that does get pumped out, some leaks back.

Heart has to work very hard to keep everything else working. Amazing that it adapts and just knows to pump harder. My pediatric cardiologist always said, “Man, your heart’s on vacation,” after my first AVR.
 

Woodcutter

New member
Joined
Oct 25, 2020
Messages
2
Not sure how common or unique my experience is so I shall share. My issue was with the mitral valve and over a relatively brief period of time I actually had both. I had a regurgitant valve that worsened to the point where action was recommended. I was asymptomatic; however, regular tests did make it clear that the leakage increased and there was some wall thickening. Heart was working harder. The body is quite adaptable but eventually a point can be reached where damage is irrecoverable. So, what I like to call an o-ring was sewed inside to stiffen things up and eliminate the leakage.

It solved the leakage but I am a runner and I literally could not run. Technically asymptomatic again . . . except during exercise. What had happened was in fixing the valve, the resultant opening was too small, i.e. stenotic. When I attempted to exercise I could feel chest pressure. The repair was causing pulmonary hypertension. On occasion I'd be coughing up blood.

My first surgeon actually asked me if I wanted him to take it out. I found another who quickly realized exactly what the problem was. He adapted a stress test to measure the mitral gradient as much as possible while exercising and it was way too high. (Essentially it was the standard stress test/ultrasound and as soon as they detected a heart anomaly they yelled at me to lie down for the measurement.) He put in a mechanical mitral valve 6 months after the repair surgery.

So for me personally, the stenosis was worse; however, I'm not sure there is much benefit in comparing them in a general sense.
 

dornole

Well-known member
Joined
Jan 5, 2014
Messages
713
Location
Minnesota, US
I still have both Mod mitral stenosis and Mod regurgitation after a procedure that improved the Stenosis and worsened the regurgitation. Hell yeah stenosis Was worse. I too was coughing up blood, couldn’t get up a flight of stairs without resting (at age 34) and couldn’t lie flat To sleep without jerking up coughing up a lung. It was terrible.
 

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