DEAR DR. DONOHUE: I have a 54-year-old son who has a left-ventricle leakage. He exercises a lot every day.

Last week he experienced pain in his right side, which turned out to be gallstones. He chooses to ignore them because of his heart condition. What will happen if he ignores the stones? – A.C.

ANSWER: When you say “left-ventricle leakage,” I take that to mean that the left ventricle’s valves are leaky. One left-ventricle valve is the aortic valve, which closes after the heart pumps blood into the aorta to prevent backflow into the heart. The other left-ventricle valve is the mitral valve, which closes to prevent blood from squirting back into the left atrium – the heart chamber on top of the left ventricle – when the ventricle contracts.

If the leakage of either valve doesn’t compromise heart function, then nothing is done about it.

People with significant aortic-valve leakage often develop heart palpitations, become breathless when they’re active and wake during the night gasping for air. Such people need surgical correction or replacement of the valve.

People with significant mitral-valve leakage suffer the same breathlessness as aortic-valve patients. They often develop swelling of the feet and ankles. They too need surgical correction.

Your son has no heart symptoms. He exercises vigorously every day. His leakage must be minor, because severe leakage usually precludes heavy physical labor or exercise.

What’s going to happen to his gallstones? He’ll probably have another attack of pain in the future. One attack all but assures a following attack. He should reconsider his stand on ignoring the stones if his doctor has advised him to have them out. The surgery can usually be done with a scope, which entails only a few small incisions.

Heart-valve disease is a common malady that is always poorly understood. The booklet on heart-valve problems can make the condition understandable. People can obtain a copy by writing: Dr. Donohue – No. 105, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have never seen you discuss gastric paresis. I am supposed to avoid roughage, but I have found that Equalactin and Benefiber give me great relief. – C.H.

ANSWER: “Paresis” means “relaxation” or “slight paralysis.” Gastric paresis is a stomach whose muscles work so sluggishly that it takes forever for food to leave it. People with the condition are full after a few mouthfuls of food, and they complain of stomach discomfort and bloating. They lose their appetite and often lose weight.

Often, gastric paresis results from faulty nerve transmission to stomach muscles. Such happens frequently in diabetes. It can happen after a viral infection of the stomach. When the parathyroid glands – the glands that control blood calcium – are not functioning, that can lead to paresis.

Usually, a low-fiber, low-fat diet is recommended. Fat delays stomach emptying, and so does fiber. Equalactin and Benefiber are both fiber materials. Why they work for you I don’t know. I don’t recommend them to others with gastric paresis. The prescription drug Reglan sometimes is helpful. There is a device that delivers electric stimulation to the stomach that is sometimes employed for this condition. Botox injected into the lower part of the stomach is another treatment.

DEAR DR. DONOHUE: Can you tell me what a P.A. is? My wife could not see our regular doctor, so they made an appointment for her with a P.A. It turned out really well, as she was efficient and nice. My wife is going to see her again so the P.A. can tell her the results of her tests. – W.C.

ANSWER: A P.A. is a physician’s assistant. It’s a college-awarded degree, and the training is quite rigorous. PAs work under a doctor, but they are quite independent in their role of diagnosing and treating illnesses. They have become valuable members of the health profession.

DEAR DR. DONOHUE: What is a congenital heart defect? Is that a blue baby? My niece just gave birth to a baby boy, and my sister told me that he has a congenital heart defect but is not blue. What’s the significance of this? – P.P.

ANSWER: “Congenital heart defect” covers too much ground to provide you with a satisfactory answer. It indicates that during development in the uterus, something went amiss during the maturation of the heart. Such things include heart-valve problems, holes between the chambers of the heart, abnormal connections between the heart and blood vessels, and abnormal wiring of the heart that produces unusual heartbeats.

Some congenital heart defects correct themselves in time. Some are so minor that they need no correction. Others are major and call for surgical intervention.

A blue baby is the result of a congenital heart defect where blood returning to the heart bypasses the lungs and doesn’t get the oxygen it should. Blood without a sufficient supply of oxygen has a dark-blue color.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 53647i5, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.