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Suggest Treatment For Severe Aortic Regurgitation
Question: I am 31 year old working in armed forces. recently in routine examination I was diagnosed with moderate AR in 2D echocardiography BUT I have doing vigorous exercises comfortable. but when I have 3D echo it shows severe AR. After all this I have panic attacks for which I am taking ativan 1mg. In addition I take ramistar 2.5mg and metoprolol 12.5mg. I am attaching my both 2d and 3d reports.Please suggest me the treatment.
Brief Answer:
No need for surgery for now, continue with ECHO every sixth months...
Detailed Answer:
Hi,
I have gone through your medical history carefully and understood your concerns.
From the examinations you did, you suffer of AR of moderate to severe stage.
As long as there is no reduction in ejection fraction (EF is higher than 55%) and left ventricle isn't dilated (left ventricle end systolic diameter LVED is less than 50mm), there is no need for surgery at the moment.
If EF will be less than 55% and LVED would be less than 50mm then you can consider aortic valve replacement.
For the moment, I advise to:
- keep monitoring through cardiac echo every 6 months.
- be careful with dental work to prevent valvular endocarditis
- continue the medications as prescribed by your doctor
Hope it was of help!
Wish you health!
Dr.Benard
No need for surgery for now, continue with ECHO every sixth months...
Detailed Answer:
Hi,
I have gone through your medical history carefully and understood your concerns.
From the examinations you did, you suffer of AR of moderate to severe stage.
As long as there is no reduction in ejection fraction (EF is higher than 55%) and left ventricle isn't dilated (left ventricle end systolic diameter LVED is less than 50mm), there is no need for surgery at the moment.
If EF will be less than 55% and LVED would be less than 50mm then you can consider aortic valve replacement.
For the moment, I advise to:
- keep monitoring through cardiac echo every 6 months.
- be careful with dental work to prevent valvular endocarditis
- continue the medications as prescribed by your doctor
Hope it was of help!
Wish you health!
Dr.Benard
Above answer was peer-reviewed by :
Dr. Prasad
After the I feel panic attacks and always bother about my heart condition.is there is any chance of sudden cardiac event in my case. Also I feel normal when I am busy but when I started thinking of adverse events I feel problem in breathing, headache and intense fear. should I go for bnp test .Also is 2d echo is ok for review. Please suggest me the right review treatment and what symtoms I have to monitor. Also suggest me exercise programme
Brief Answer:
Following answers to your queries...
Detailed Answer:
Hi back XXXXXXX
1. If I was your caring doctor would advise to continue taking ramipril and betablocker as they will improve your current health problems.
2. There is no need to go for bmp test in your case. If I was your caring doctor would schedule cardiac echo every 6 months as following up.
3. Cardiac exercise is the one I commonly advise to my patients with the same problems as you.
You should look for symptoms like: swollen leg, difficulties in breathing, all these will reduce the exercise tolerance. That's why you should monitor such symptoms.
4. With regards to exercise programe, moderate to high-intensity aerobic exercise are recommended. Unless you notice the symptoms as mentioned above. Then, you should stop or go for walking.
All the best!
Following answers to your queries...
Detailed Answer:
Hi back XXXXXXX
1. If I was your caring doctor would advise to continue taking ramipril and betablocker as they will improve your current health problems.
2. There is no need to go for bmp test in your case. If I was your caring doctor would schedule cardiac echo every 6 months as following up.
3. Cardiac exercise is the one I commonly advise to my patients with the same problems as you.
You should look for symptoms like: swollen leg, difficulties in breathing, all these will reduce the exercise tolerance. That's why you should monitor such symptoms.
4. With regards to exercise programe, moderate to high-intensity aerobic exercise are recommended. Unless you notice the symptoms as mentioned above. Then, you should stop or go for walking.
All the best!
Above answer was peer-reviewed by :
Dr. Prasad
After the lunch whenever I sleep and changes sleeping position the heart beat louder and fast. is this a matter of concern. Also suggest whether 2D echo is ok for review as my near 3d echo is not available. Also I am panic about sudden cardiac event in my case. Please suggest me how to overcome this panic
Brief Answer:
Following answer to your query...
Detailed Answer:
Hi back,
1. It's normal that heart beats louder and fast while you sleep after meal, and you shouldn't be concerned about that.
2. 2D echography is ok for the regular follow up (review) of your heart conditions, which as I mentioned earlier should be done every sixth months.
3. You should be relaxed there isn't any increased risk for sudden death, the only increased risk is for developing heart failure. This is why you should run every sixth months 2D cardiac echo. For the moment everything is ok. I suggest to hink positive, increase recreational activities and sport in order to manage anxiety and avoid unnecessary stress. More over I would recommend valeriana and chamomile tea to help you with your anxiety.
Hope this was of help!
Wish you health!
Dr Benard
Following answer to your query...
Detailed Answer:
Hi back,
1. It's normal that heart beats louder and fast while you sleep after meal, and you shouldn't be concerned about that.
2. 2D echography is ok for the regular follow up (review) of your heart conditions, which as I mentioned earlier should be done every sixth months.
3. You should be relaxed there isn't any increased risk for sudden death, the only increased risk is for developing heart failure. This is why you should run every sixth months 2D cardiac echo. For the moment everything is ok. I suggest to hink positive, increase recreational activities and sport in order to manage anxiety and avoid unnecessary stress. More over I would recommend valeriana and chamomile tea to help you with your anxiety.
Hope this was of help!
Wish you health!
Dr Benard
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
GERD/anxiety aggravating your symptoms...
Detailed Answer:
Hi back,
GERD would aggravate your symptoms together with trouble in breathing.
Actually, trouble of breathing is also caused by anxiety, which is also aggravating your symptoms.
I'd advise to try to control anxiety/stress. Breathing fresh air and light to moderate physical activities can also help. Herbal remedies for stress/anxiety like chamomile/aloe vera/valeriana tea can also help.
If they will fail to help you, then, should consult with your doctor to start the most suitable medications.
Psycho-therapy can be another option too.
All the best!
Dr.Benard
GERD/anxiety aggravating your symptoms...
Detailed Answer:
Hi back,
GERD would aggravate your symptoms together with trouble in breathing.
Actually, trouble of breathing is also caused by anxiety, which is also aggravating your symptoms.
I'd advise to try to control anxiety/stress. Breathing fresh air and light to moderate physical activities can also help. Herbal remedies for stress/anxiety like chamomile/aloe vera/valeriana tea can also help.
If they will fail to help you, then, should consult with your doctor to start the most suitable medications.
Psycho-therapy can be another option too.
All the best!
Dr.Benard
Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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