Q: I am 64 years old. My echocardiogram in 1994 & 2003 showed a perfect heart. This year it showed mild to moderate mitral valve leakage. The ejection factor of heart has always been 70%. The rest is fine. Could stress have caused this? I have an extremely stressful sales job and drink a lot of caffeine. There is no prolapsed valve. I always have irregular heart beat. The Doctor says this is harmless. Will this valve condition shorten my life? What caused it? Is it serious? Will it progress fast or slow? My blood pressure is about 116/68-59 to 142/78-75 during the day. Under extreme stress it once jumped to 171/87-89. Could this condition of leakage actually get better with retiring into a more relaxed lifestyle or is it permanent and will get worse? I never had any health problems earlier.

A:Valve leakage could be due to a multitude of causes and some times it is impossible to lay one's hand on the cause, especially on a communicated report. Cause of the leakage of the valve can only be decided on Echocardiogram and therefore it is difficult to pin point the exact cause in your case. However, theoretically it could be degenerative in nature or what we call, myxomatous degeneration in which the tissues become little lax and the valves start leaking. In any case, with mild leak in the valve and with a normal heart function with no dilatation or increase in the size of the heart, one doesn’t have to worry about this, excepting getting a yearly echocardiography done. If the valve's leak progresses, then it can be tackled by valve repair procedure which can be either performed surgically or now a days in certain good centres, even performed percutaneously. I don’t think, stressful job or caffeine has anything to do with it. Myxomatous degeneration is essentially an inherited problem and your life style would not matter in this.