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tricuspid and mitral regurgitation

I have a history of tricuspid regurgitation (discovered in 2004) and mitral regurgitation (discovered in 2008). As they are rated as mild, therefore I have not built up an habit to have the follow-up annually.

In this year, however, I started to suffer from more frequent attacks of lost of consciousness (three times in this half-year). Actually, I have been suffering from such lost of consciousness occasionally since my primary school years (more than 20 years ago). It was only until 2004 that I was sent to hospital and diagnosed with a mild tricuspid regurgitation and vasovagal attack (tilt table test result as positive, mixed type).

The situation of this year seems to have become worse as I suffered from more frequent episodes of lost of consciousness. Every time I was diagnosed as having vasovagal attack in A & E after electrocardiogram.

I understand all diagnosis can only be confirmed with clinical examination. But may I ask for your kind opinion if I can just perceive these symptoms as simply vasovagal attack, or they are reflecting some other problems as well? Also, should I resume annual echocardiogram check-up on my heart valves annually? (Some doctors said I should, but some said no because my tricuspid and mitral regurgitation is rated as mild only.)

Thank you very much for your advice in advance.
According to the features you described, vasovagal syncope is one of the possible causes for your recurrent syncope. Unfortunately, there is no definitive treatment for this condition up till now. I would suggest some general measures to avoid or alleviate the attacks such as keep good hydration, avoid prolonged standing, to lie down whenever you have the feeling that you are going to have the attack, etc. However, if you still have frequent syncope attacks that are disturbing your daily life, you better seek further professional assessment and opinions from cardiologist as we need to look for or rule out some other malignant conditions such as intermittent heart block or ventricular arrhythmias.

For the mild mitral and tricuspid regurgitation, it is not uncommon to get these finding during routine echocardiogram. I think it is advisable for you to have another echocardiogram done after so many years to see the progress of the condition. If the echo still shows mild mitral and tricuspid regurgitation, you can just have routine echo check in every few years in order to monitor the condition.

Dr. Chan Chi Kin Hamish

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