Heart murmur, PVCs and multiple cardiac risk factors

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Submitted by Dr T on August 23, 2013 – 9:25am

24 years ago I was told that I had a heart murmur.  Within a month of that time I found out I was pregnant.  Following up through the pregnancy and after I had the child the doctors still could hear the murmur and could see it on the heart sono (echocardiagram?).  Anyway, as time went on, my doctor didn’t mention it and I completely forgot about it.  Fast forward to today and I have a problem with PVCs.  I’ve had to failed ablation attempts.  I also have a big problem with high blood pressure (at my worst I was on 3 different meds twice a day).  7 months ago I had bariatric surgery and my pressure went down, I dropped to one pill (Cardizem 240) once a day.  Within the last couple of weeks my pressure has shot up again (at my cardiologist direction, I take my pressure twice a day).  My PVCs are now back along with dizziness and shortness of breath.  My heart rate is now regularly in the upper 40s – low 50s.  Yesterday my sister called to inquire about my heart murmur history (she just found out she has one) and reminded me that I had been diagnosed years ago.  I’ve never mentioned it to any of my current doctors and I’ve had multiple stress tests and surgical and dental procedures.  After all of this time I’m embarrassed to tell my doctor that I forgot about having a heart murmur years ago.  I’m assuming that it just went away.  Is this something I even need to mention at this point? 

Hi Rhonda,

I cannot believe your doctors don’t know about it – even without you telling them, but then, anything is possible I guess. Be that as it may, your new symptoms are of concern and should be evaluated. I also think you are overmedicated with cardizem 240 mg/day and should ask to be have your meds changed for a start. Patients whose ablation procedures have failed are in a special category anyway and should be followed very carefully.

Any testing should include another (stress) echo of your heart as well as other tests. Any echo will automatically include an evaluation of your heart valves and since you have had stress tests before there is no way a valve problem would not have been noted. However, if there is a vlave issue I suspect either a floppy mitral or a bicuspid aortic valve to be the culprit of the heart murmur (unlikely to go away but also unlikely to present a clinical propblem at this point).

Since you have multiple risk factors for coronary artery disease (CAD) that should be excluded immediately as part of the evaluation. New onset PVCs are often associated with CAD.

Thus, Yes! You need to get going with your doctors!

Hope this helps,

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