DEAR DR. DONOHUE: About 40 years ago, when I was in my 30s, I was examined by a famous heart doctor who went over me with great care and concluded I had mitral valve prolapse. He put me on medicine, which I have taken to this day. He also insisted I take antibiotics before dental work.

That doctor died, and my new doctor, quite young, says I don’t have mitral valve prolapse and that I don’t need medicine or antibiotics before dental work. He saw that I doubted him, so he had me get an echocardiogram. It showed no mitral valve problem. I still wonder about this. I can’t accept that my former doctor was wrong. — J.P.

ANSWER: The mitral valve regulates blood flow from the upper left heart chamber — the left atrium — to the lower left heart chamber, the ventricle. When the ventricle contracts, it pumps blood out of the heart. Simultaneously the mitral valve closes to prevent backflow of blood into the left atrium. Mitral valve prolapse means that the mitral valve balloons upward into the left atrium during heart pumping and might leak blood.

In the 1960s, around the time you were diagnosed with this condition, mitral valve prolapse was first described and became a very popular diagnosis. Many of those who were then given a diagnosis of it really didn’t have it. The condition was written about in newspapers and magazines, and dire consequences were ascribed to it.

Now, with new knowledge of how this valve works and with new equipment such as echocardiograms (sound wave pictures of the heart), a clearer picture of the mitral valve is obtainable. Most people who have a ballooning valve are not considered to have a serious medical condition. In only a handful of these people does a significant leak of blood occur. Those are the people who require treatment, and those are the people who take antibiotics before certain dental procedures.

Your doctor wasn’t wrong. He was a victim of the inadequate knowledge of that era.

Heart-valve disease is quite common. The booklet on it describes the more prevalent varieties. Readers 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 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My husband, 78 years old, fell off a ladder, and his head struck the sidewalk. I insisted he go to the emergency room, although he put up a fight.

In the ER, the examining doctor gave him a very complete examination. He ordered a CT scan of his brain. The doctor found nothing wrong, and the scan was said to be normal. They sent us home.

This week we got a report of the scan. It says my husband has brain atrophy. I had to look up the meaning of atrophy. My husband was never an Einstein, but what is the significance of brain atrophy? He carries on a reasonable conversation, and he reads the paper carefully. Need we be concerned? I’m upset. He isn’t. — W.Y.

ANSWER: Atrophy means shrinkage. If everyone your husband’s age had a brain scan, most of their reports would say brain atrophy. It’s something that happens with age.

It doesn’t imply any serious trouble. It shouldn’t scare you or him.

DEAR DR. DONOHUE: Is it possible for a man with prostate cancer, before it is treated, to pass the cancer to his wife through intercourse? This subject came up during lunch with friends. Some said it was possible. — C.N.

ANSWER: Prostate cancer is not passed from a man to his wife through intercourse or in any other way.

DEAR DR. DONOHUE: This is a silly question, but I’d like to know: Why do men spit so much? Baseball players do it all the time. — L.L.

ANSWER: I don’t know. It might be a habit. Baseball players get dried out and their saliva thickens. That’s one reason they spit. Some chew tobacco. Another reason.

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 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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