Heart Valve Damage

Since my first PPM implant over 5 months ago, I've been dizzy and weak. Some days are worse than others. I noticed a pain in the center of my chest, and asked the Tech whether leads can be felt in the heart. He said sometimes patients can feel the leads rubbing against the heart valves, but not the screws embedded in the heart. Since my PPM is now totally removed, I don't feel the pain any more, but still get dizzy and weak.

That put me to thinking, and I looked up the symptoms of valve regurgitation. Bingo. I nagged my cardio until he gave me an echo. Bingo again. According to his nurse, who phoned and read the results to me robotically, "3 valves have regurgitation. On a scale of 1 to 4, the regurgitation is a 1. You will be scheduled for another echo in 6 months".

3 valves? Surely she means the tricuspid valve, and not 3 different valves.

Since my echo was clean before the implant, I can only surmise 2 possibilities. Either the valve was damaged while inserting or removing the leads, or I have (or had) an infection.

Has anyone experienced valve damage during PPM or ICD implant surgery, and what is the usual prognosis?

I'm supposed to get a new PPM in 2 weeks, after my incision has fully healed. Is there now greater danger of more valve damage, and does this in fact rule out another PPM?

Many thanks,,,

Bob A.

6 Comments

a study

by Angelie - 2008-11-12 02:11:00

After posting earlier, I decided to pay more attention to valve regurgitation while at work today. Here's what I found. Interesting info.
44yr old, mild regurg X 1 valve
76yr old, mild X 4 valves
65yr old, mild X 3 valves, 1-moderate
87yr old, mild X 2 valves, 1-moderate
25yr old, trace X 2 valves, 1- mild
52yr old, mild x 3 valves,
74yr old, mild x 1 valve, 1-moderate
60yr old, mild x 4 valves
77yr old, mild x 2valves, 1-moderate, 1-trace
44yr old, mild x 2 valves, 1-moderate

That's 10 out of 10 patient's ECHOs where valve regurgitation was found.

Hi Bob,

by Gellia2 - 2008-11-12 09:11:12

The pacer's wires also have to thread though some of the valves.
This can cause slight regurgitation through those valves. If it's the same ones, you may want to ask if this is the causative factor. Many people also have mitral valve prolapse which is pretty common.

Best to you,
Gellia

Good to Have an Expert!

by bobad - 2008-11-12 10:11:49

Angelie,

Thanks for the informative reply! I guess I'll live then! :)

Why couldn't my doctor or his nurse have explained it like you did? I bet that echo will cost me US$500 or more, and it came with no instructions. Then, some kind stranger did my doctor's job free of charge.

Assuming our "levels" are compatible 1=trace, 2=mild, etc, then my regurg is very minor. It should be asymptomatic, not even close. So the source of my chest fullness, weakness, and dizziness are still unknown. The nurse didn't mention ejection fraction, so I suppose it's within normal limits.

My main question was, has anyone experienced valve damage caused by PPM leads. Sounds like it's a rare occurrence, but it seems that everything that happens to me is rare!

Thanks again! Your info is much appreciated!

Bob A.

Regurg is actually very common

by Angelie - 2008-11-12 10:11:53

I'm 33 and have mild valve regurgitation in my tricuspid, mitral, and pulmonic valves for YEARS. I've only had my pacemaker for 3 months, and have not had a ECHO since my implant.
Valve regurgitation is quite common, especially as we get older. It simply means that when the heart pumps blood through the heart valve that a portion of that blood goes backward through that valve. Most of the time, this backward motion of bloodflow causes a heart murmur, or abnormal heart sound. It's rated as trace, mild, moderate, and severe. Trace and mild regurgitation is seen so commonly in people that most doctors don't even mention it to their patients. The doctor might choose to do annual ECHO's just to make sure the regurgitation doesn't get any worse. I have not had an ECHO for about 3 years now, and 3 of my heart valves have these insuffiencies.
I work in a Cardiology unit at our local hospital. I read ECHO dictations for a good part of the day. I see regurg on about 95% of the patients. I would say that regurgitation in heart valves is really no big deal unless it reaches the moderate-severe point. Otherwise, it doesn't cause much problem to the patient.
I can't tell that 3 of my heart valves are leaky at all, and my cardiologists don't seem all that concerned about it. Worrying about it, just causes me more stress that I don't need. I can't tell any difference either since my pacemaker implant as far as my heart valves go. I still have murmurs, but probably always will.
Hope this information helps you out some.

Hi

by Karen - 2008-11-12 11:11:28

I had an echo done in 2000 and a pm put in 2001. Echo done this year in 2008. they said my echo has changed since 2000 and that I have 3 leaky valves. My present cardiologist is sending me to a specialist to see what is going on.They also noticed right side pressures are different too.

You're welcome

by Angelie - 2008-11-12 11:11:41

I'm, of course, no doctor but you'll find that on this site you usually do run into someone that knows A LOT about what you're going through. And that person can usually explain it better than most doctors can. I'm glad that I was able to help you out. I was in my late twenties when I realized that I had 3 heart valves with regurg, and that was when I requested a copy of my ECHO report. My doctor, suprisingly, didn't mention the problem at all to me. In fact his exact words at check-up time were, "well your ECHO came back normal."
When I got the report myself and read it, I was like, "Normal! What about this echo is normal?" I began my hunt on anything I could about heart valve insuffiencies through internet searches or any book I could read. Then a couple of years ago, I decided to work in our cardiology dept. (since I have problems myself) and have found that it's VERY common. Hee,hee.
You and I seem to have the similar problem of rarities happening to only us. Everything medical- that is, happens to me so much that I joke with my doctors that my middle name is Murphy's Law. If it's a rare side effect that happens to about 1% of the other patients in the entire world......it will happen to me. It's frustrating. I know a little about what you must be going through. I choose to laugh about it most of the time. My wonderful "Luck" makes for great stories, and besides what else can you do about it other than accept it the best you can and laugh. Plus, I think I look ugly when I cry. I'd rather laugh any day. It's more flattering.
Happy trails my friend,
Angelie

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