Question

A 42 yo stockbrokwer with a known heart murmur of 10 yrs duration is experiencing increasingly severe SOB and fatigue

An echo reveals severe mitral valve regurg

what is the dx
what is the tx

Answer 1

The diagnosis for the 42-year-old stockbroker with a known heart murmur of 10 years duration experiencing increasingly severe shortness of breath (SOB) and fatigue, along with a severe mitral valve regurgitation revealed by an echo, is Mitral Valve Prolapse (MVP). The recommended treatment includes close monitoring, lifestyle modifications, and, if necessary, surgical intervention such as mitral valve repair or replacement.

Step-by-step explanation:

Mitral Valve Prolapse (MVP) is a condition where the valve between the left atrium and left ventricle of the heart doesn't close properly, causing blood to flow backward into the atrium. This regurgitation can lead to symptoms like shortness of breath and fatigue, as seen in the stockbroker. The duration of the known heart murmur and the severe mitral valve regurgitation on the echo support the diagnosis.

Management of MVP involves regular monitoring, especially if symptoms worsen. Lifestyle modifications, such as avoiding stimulants like caffeine and managing stress, are crucial in mitigating symptoms. In cases of severe regurgitation, surgical intervention may be recommended. Mitral valve repair or replacement aims to restore normal valve function and prevent further complications.

In summary, the combination of the patient's symptoms, known history of a heart murmur, and the findings on the echo point towards Mitral Valve Prolapse as the likely diagnosis. The treatment approach includes a combination of close monitoring, lifestyle adjustments, and potential surgical intervention for severe cases.

Answer 2

A 42-year-old stockbroker experiencing shortness of breath and fatigue has been diagnosed with severe mitral valve regurgitation. Initial management includes medical therapy with possible progression to surgical repair or replacement of the mitral valve, based on the severity and symptoms.

Step-by-step explanation:

The stockbroker with a heart murmur and symptoms of shortness of breath (SOB) and fatigue has been found on echocardiogram to have severe mitral valve regurgitation. This condition is characterized by the inability of the mitral valve to close properly, which leads to the backflow of blood from the left ventricle into the left atrium. Over time, this can result in congestive heart failure due to increased workload on the heart and dilation of the left ventricle. As the condition progresses, symptoms like SOB, fatigue, and eventually signs of heart failure may become prevalent.

Treatment for severe mitral valve regurgitation typically starts with medical management, including the use of diuretics and other medication to reduce the workload on the heart and manage symptoms. In severe cases where the patient's condition deteriorates, or in the case of exacerbating symptoms, surgical intervention such as mitral valve repair or replacement may be necessary. The decision between repair and replacement will depend on various factors, including the severity of the regurgitation, the anatomy of the valve, the presence of symptoms, and the overall health of the patient.