Question

I recently had several heart tests, and the results have me worried. I am 61 and have high blood pressure but it is well managed with medication. I have three leakages in my heart and have a 50% blockage in both my arteries in my neck. I have aortic insufficiency, mitral and tricuspid valve regurgitation. The doctor doesn't see any need for anything further for me now. I have severe chest pain at times. Do I need to get a second opinion?

Answer

The "leakages" that your doctor is referring to are the aortic insufficiency, mitral regurgitation and tricuspid regurgitation. The terms regurgitation and insufficiency means that the valves are not functioning properly and blood is "leaking" back.

If your aortic insufficiency is bad enough it may cause anginal chest pains. These pains can be treated medically but if bad enough a prosthetic aortic valve can be inserted surgically. A cardiac echocardiogram can measure the degree or percentage of insufficiency to determine if you may need a prosthetic valve. You might want to discuss this with your doctor.

The carotid arteries can function very well supplying blood to your brain with a 50% opening. You might ask your doctor to measure your lipids (cholesterol) to see if they are high. Increased lipids can worsen the carotid blockages. If they are high then you can be prescribed a lipid lowering medication.

Do you need a second opinion? It seems as if your doctor has done well to inform you of your problems. Maintaining control of your blood pressure is exactly what you need. You might tell her/him of the severity of your chest pains so they may be more fully evaluated and, if needed, treated. Also I suggest a referral to a cardiac specialist (a cardiologist) who may be better versed in your problems than your family doctor. Then both doctors can maintain your health by communicating with each other.