After a bunch of midnight fluttery fibrillation episodes and general weakness, I went in for the requisite stress & echo tests. They showed the standard athlete’s heart stuff: bradycardia and oversized this & oversized that. However, the echo also showed a murmur from a leaky mitral valve (not MVP).
Now, I was examined by a GP and a (different) cardiologist only 9 months ago. Neither one noticed a murmur at that time.
So my questions to you heart-savvy types and cardiologists are: do you know of any training or illness factors that might cause leaky valves (e.g. overtraining, training too hard while sick, etc.)? And What chance is there of a cardiologist missing a murmur?
While, we’re at it, is there any chance of this going away? Pumping the same blood twice sounds pretty inefficient from a performance perspective. ;-(
Bearing in mind that I’m not a doctor (though I should be starting medical school fall 08 and I’ve worked in hospitals for a few years READ: I have no real training), strep as I understand it, if untreated can cause Rheumatic Fever. The body can fight this and does. The antigen that the antibodies recognize is very similar to the surface glycoprotiens of the valves. As a result, it can take years for these to actually target the valvular tissues.
I’m not quite sure what the treatments are, but this is one way that I’ve heard of idiopathic heart valve damage occurring. I’m not sure if that helps or not, but as my disclaimer said, I am neither a cardiologist nor a doctor. I’m sure a quick internet search will yield more specific information related to your condition. I wish you the best!
Echos will find many valve problems that nobody (or at least many people) can’t hear. I think many smaller leaks and some large leaks are very quiet.
Its a lot easier to hear a murmur that you know is there…
Training (or other stressors) while ill (viral) may increase the risk of myocarditis which can cause valve problems (or at least it seems like it could)
How often do athletes get echos? Is there a data set out there? Do many “enlarged” hearts from athletics lead to some leakage as the valve size/shape may not accomodate enlargement well? I have no idea. I doubt many cardiologists do either. You could do some searches and see if you find anything - if you do - let me know.
How bad was the mitral regurgitation? Were there any other problems with the valve itself?
The degree of leakage may change or go away in some situations - decreased blood flow that was then fixed or maybe if you raced an ironman just before the echo or maybe if you had myocarditis that then improved with time or maybe if you had heart failure that was then treated…depends on the underlying cause.
Whats your age and did they find a-fib? What did the cardiologist say re: valve/a-fib…
Echos will find many valve problems that nobody (or at least many people) can’t hear. I think many smaller leaks and some large leaks are very quiet.
Its a lot easier to hear a murmur that you know is there…
This one is apparently audible. I’m sure you’re right though: If you see it on the echo, then you would know to listen for it in a certain place.
How often do athletes get echos? Is there a data set out there? Do many “enlarged” hearts from athletics lead to some leakage as the valve size/shape may not accomodate enlargement well? I have no idea. I doubt many cardiologists do either. You could do some searches and see if you find anything - if you do - let me know.
This is why I’m posing questions here. This might be one of those cases where the collective experience of athletes and what their doctors found might be more instructive than that of a specialist who only sees one or two athletes a year. Incidentally, I haven’t been able to find anything in Pubmed on it other than this:
How bad was the mitral regurgitation? Were there any other problems with the valve itself?
Not bad enough that surgery would be indicated. No other valve problems.
The degree of leakage may change or go away in some situations - decreased blood flow that was then fixed or maybe if you raced an ironman just before the echo or maybe if you had myocarditis that then improved with time or maybe if you had heart failure that was then treated…depends on the underlying cause.
Whats your age and did they find a-fib? What did the cardiologist say re: valve/a-fib…
I’m 45. We have not yet been able to capture the a-fib via holter monitor, etc. The cardiologist suggested that a-fib is more likely with athlete’s heart, with or without valve problems.
While, we’re at it, is there any chance of this going away? Pumping the same blood twice sounds pretty inefficient from a performance perspective. ;-(
Keep in mind that flow rates are 10X or so greater during exercise than when you’re at rest. If you’ve got slight to moderate regurgitation I doubt it will affect your performance at training or race intensities.
I had an insurance evaluation years ago because some 70 year old doing insurance physicals heard a murmur. Cardiologist heard no murmur but did an echo to pacify insurance co. Result? Mitral and tricuspid regurgitation. Significance? Absolutely none, other than getting a rate change from that company.
Just because they can see these things on echo, and hear them when they turn on the doppler, doesn’t mean you have a true murmur(a murmur can only be heard with a stethoscope, not seen) or a significant defect. Now, I was and am completely assymptomatic. I’m a physician and could have it looked at again if I wanted. But in medicine, you treat the patient, not the test.
And BTW, strep/ rheumatic fever generally causes mitral stenosis (narrowing).