Floppy heart valve - can anyone help?

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I’ve posted this on the General Health board but it doesn’t get much traffic.

Before Christmas my DM went to the doctors for a chest infection. The chest infection cleared up but the doctor told her it sounded like there was a valve in her heart flapping and sent her for a scan. She said if that was the case then she’d need an operation.

My DM went for the scan on Monday, and the doctor rang her and said that it was floppy and she’d need an operation.

Today she has received a letter from the cardiologist asking her to go to an appointment on 26th March.

Obviously we’re terrified. I can’t eat and feel sick all of the time. The GP only rang my DM rather than seeing her face to face, and said she couldn’t really answer any questions because she wasn’t an expert. It says online that many people don’t need an operation for this condition. Will the GP definitely know she will need one, or could she just be assuming so? It seems so wrong to leave us all scared and confused until 26th March with no real idea what is going on. I’m getting horrific thoughts and struggling to cope.

OP, ex-cardiothoracic surgeon with multiple publications on mitral valve surgery here.

"Floppy valve" will be regurgitant valve, either aortic or mitral. First decision is whether the regurgitation is severe enough to warrant intervention or not. As well as severity of the regurgitation, how it has affected heart function and several other parameters also need to taken into consideration. Some cases are easier to decide on, others are not, and these are discussed at multidisciplinary meetings between cardiologists and cardiothoracic surgeons.

If it is decided to offer the patient intervention, the next decision is the types of interventions that can be offered. Not all interventional procedures are surgery! The available options, their attendant risks, benefits and complications would then be discussed with the patient. The final decision is for the patient to make with the help of the cardiac/cardiothoracic surgeon who would be performing the operation.

If you'd like more information or to ask more questions, feel free to PM me.

That’s amazingly helpful, thank you so much for your time.

Should we be placing much weight on the GP saying that it will be surgery, then? We’re not sure if we should be mentally preparing for surgery or what - we thought the next stage was going to discuss the surgery until she got a very blasé letter inviting her to discuss it when the cardiologist (which was heartening), or if we should disregard the GP’s thoughts on surgery and wait to see what happens.

It depends on a combination of the degree of regurgitation, the anatomy of the flail segment(s) of the valve, the effect of the regurgitation on the structural function of the heart, the patient's symptoms, and their co-morbidities. Without assessing all of those, nobody should say definitely surgery or not. The GP should be able to provide a rough guide regarding the chances, but absolutely no definitive statements. That's what the surgeon and the cardiologist are there for! Don't get me wrong, I have huge respect for GPs, Mrs Unicorn herself is a GP, but they should not make categorical statements of that kind. The GP isn't going to be the one doing the procedure so I'd wait to see what happens.