Mitral Valve Prolapse: Symptoms, Risks, and Management

Mitral valve prolapse

Hello, I previously asked you a few questions and later visited the outpatient clinic, but I still have some doubts.
I would like to consult with the doctor regarding the possibility of mitral valve prolapse (which I believe is likely).
Sometimes I experience chest tightness and pain, as well as toothache while chewing (no cavities).
Occasionally, I feel a bit dizzy, but not to the point of fainting.
Deep breathing helps alleviate some of the discomfort.
Earlier, I also had gastroesophageal reflux and have been coughing, which seems to originate from my chest.
Sometimes I feel pressure, sudden unexplained nervousness or anxiety, and occasionally experience palpitations.

I would like to know if leaving these symptoms untreated could lead to difficulties in treatment or worsening as I age.
Previously, I visited a family medicine doctor who prescribed medication but mentioned that it only addresses the symptoms and not the root cause.
How should I manage these symptoms to prevent them from worsening? The medications prescribed were Xanax and antiarrhythmic medication, and I had an ECG done which showed slight abnormalities.
Additionally, I have two nodules on the right side of my thyroid, each measuring 0.4 cm.
Although the tests indicated they are benign and require monitoring, I was diagnosed with them last year, and I had another health check-up in early November this year.
Recently, I have also experienced occasional nausea, but it’s not due to reflux; it feels like a slight urge to vomit coming from my neck, similar to a tight sensation, but it’s not painful or nauseating.
Is it possible for the nodules to suddenly worsen or grow larger within a month or two after being checked?
In the past two months, I have frequently experienced belching, which seems to come from my stomach or esophagus, although it has no particular odor.
It occurs quite often, especially when I jog, and I often feel like something is about to come up, though it doesn’t lead to vomiting.
I also feel that I am passing gas more frequently, but it seems superficial and loose.
Could these symptoms be related to my heart, thyroid, or gastroesophageal reflux? Thank you.

l, 30~39 year old female. Ask Date: 2016/12/18

Dr. He Dongjin reply Cardiology

Hello, the symptoms you are experiencing are still manifestations of autonomic nervous system dysregulation.
When jogging, the sensation of something wanting to come out, along with the feeling of air rising, may be caused by gastroesophageal reflux.
The thyroid gland typically does not suddenly worsen or enlarge within one to two months after a check-up; this is unrelated.
If left untreated, it will not necessarily become difficult to manage or worsen as you age, so there is no need to worry.
You should be able to continue taking Zanaflex and antiarrhythmic medication.
Changhua Hospital is concerned about your well-being.

Reply Date: 2016/12/18

More Info

Mitral Valve Prolapse (MVP) is a condition where the two flaps of the mitral valve do not close properly, which can lead to various symptoms and complications. Understanding MVP involves recognizing its symptoms, associated risks, and management strategies.

Symptoms of Mitral Valve Prolapse
Patients with MVP may experience a range of symptoms, although many individuals remain asymptomatic. Common symptoms include:
1. Chest Pain or Discomfort: This can manifest as a feeling of tightness or pressure in the chest. It is important to differentiate this from angina, which is related to coronary artery disease.

2. Palpitations: Many patients report feeling their heart racing or fluttering. This can be due to arrhythmias that may occur with MVP.

3. Dizziness or Lightheadedness: Some individuals may experience episodes of dizziness, particularly during physical exertion or stress.

4. Anxiety and Panic Attacks: The irregular heartbeats associated with MVP can sometimes trigger anxiety or panic attacks.

5. Gastroesophageal Symptoms: Symptoms such as gastroesophageal reflux disease (GERD) and associated cough can occur, as the diaphragm and esophagus are in close proximity to the heart.

Risks Associated with Mitral Valve Prolapse
While MVP is often benign, there are potential risks and complications:
1. Mitral Regurgitation: This is a condition where blood leaks backward through the mitral valve, which can lead to heart enlargement and heart failure over time.

2. Arrhythmias: Patients with MVP may be at increased risk for atrial fibrillation and other arrhythmias, which can lead to complications such as stroke.

3. Infective Endocarditis: Although rare, individuals with MVP are at a slightly higher risk for infections of the heart valves.

4. Psychological Impact: The symptoms of MVP can lead to anxiety and depression, which may require management.

Management of Mitral Valve Prolapse
Management strategies for MVP depend on the severity of symptoms and the presence of complications:
1. Regular Monitoring: For asymptomatic patients, regular follow-up with echocardiograms may be sufficient to monitor the condition.

2. Medications: Beta-blockers may be prescribed to help manage palpitations and anxiety. In some cases, medications for GERD may also be necessary.

3. Lifestyle Modifications: Patients are often advised to adopt a heart-healthy lifestyle, including regular exercise, a balanced diet, and stress management techniques.

4. Surgical Intervention: In cases of significant mitral regurgitation or heart failure, surgical options such as mitral valve repair or replacement may be considered.

Concerns About Progression and Treatment
You expressed concern about the potential for MVP to worsen over time, especially with the presence of symptoms like chest pain, dizziness, and gastrointestinal issues. While MVP can lead to complications, many patients live normal lives without significant issues. However, it is crucial to address symptoms as they arise and maintain regular check-ups with your healthcare provider.

Regarding your thyroid nodules, it is good that they have been evaluated as benign. Regular monitoring is essential, but the likelihood of sudden changes in size is generally low. If you experience new symptoms, such as nausea or increased gastrointestinal discomfort, it is advisable to discuss these with your doctor, as they may warrant further investigation.

In summary, MVP can be managed effectively with appropriate medical care and lifestyle adjustments. Regular follow-up with your healthcare provider is essential to monitor the condition and address any emerging symptoms or concerns. If you have ongoing symptoms or new developments, do not hesitate to seek further evaluation and guidance from your healthcare team.

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