Can my leaky valve cause shortness of breath?

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Submitted by Dr T on June 18, 2014 – 4:54pm

Question: 
Thank you for your time and expertise.  I just got the results of my echocardiogram in the mail.  I am a 45yr female.  I had an avnode ablation after unsuccessfully trying to ablate multiple arrythmias, including aberrant afib.  I currently have a pacemaker.
My echo states:
Tricuspid valve: moderate regurgitation
Right atrial pressure: 5mmHG
Peak tricuspid insufficiency gradient: 38 mmHG
Estimated right ventricular systolic pressure:  43mmHG
Could you help me understand what those number mean.
My other question relates to exertion.  I have significant symptoms when i do basic exercise.  2 flights of stairs leaves me completely breathless.  My nuclear stress test had my baseline at 78bpm.  Peak was 105bpm.  Could the lack of rise in heart be causing my excersize intolerance?
Hi Christine,
  • The data suggest evidence of some right heart failure that may explain your shortness of breath with minimal exertion.
  • Your pulmonary valve is leaking, which could be the result of a problem with the valve itself, or secondary to “Pulmonary Hypertension” (plus a couple of other things, but less likely I think).
  • Whether your symptoms and the echo results are related to the ablation procedure I can’t tell from this information.
  • Your max heart rate is probably  your pacemaker at work, and your heart may no longer be able to beat faster.
If what I suggested is true, than you should be treated for your symptoms of heart failure. This evaluation should also evaluate you for coronary artery disease, because women often have atypical symptoms. I suggest you ask your doctor for a stress test as the next step. 
Hope this helps,

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