Left Chest Pain and Weakness: Is It Mitral Valve Prolapse?

Left chest tightness and weakness?

Hello Doctor,
I am a person who tends to worry easily.
I have mitral valve prolapse and have experienced mild myocardial ischemia when my heart rate is very fast (around 170 bpm).
Recently, for the past two months, I have often felt a vague discomfort in the left side of my chest, along with a sense of weakness that also affects my left arm.
This sensation occurs seemingly without reason, possibly while using the computer, scrolling on my phone, or even just daydreaming.
It can happen 2 to 3 times a day, with each episode lasting 1 to 2 hours, which makes me quite anxious, especially the so-called "weakness in the left side of my chest," leaving me unsure of what to do.

Could these symptoms be caused by my mitral valve prolapse? If it is related to the mitral valve prolapse, can it occur suddenly and without warning? I have previously consulted a cardiologist who, considering my young age, concluded that I have autonomic nervous system dysregulation.
However, this discomfort significantly affects my daily life.
I have also seen a psychiatrist who diagnosed me with anxiety and panic disorder.

Additionally, after exercising (cycling), I have experienced chest pain on the left side, feeling as if someone is squeezing my heart.
At that moment, the pain was quite alarming, and I considered taking nitroglycerin but was unsure if it was appropriate.
Is it advisable to take nitroglycerin and Xanax when my heart rate is still at 120 bpm after exercising? I have also noticed that my heart rate sometimes fluctuates, speeding up or slowing down by a beat.
Is there a need for further treatment for this?
Thank you, Doctor, for taking the time to respond!

Cheng, 30~39 year old female. Ask Date: 2017/06/11

Dr. He Dongjin reply Cardiology

Hello, your symptoms indicate mitral valve prolapse combined with autonomic nervous system dysfunction, which has recently evolved into anxiety and panic disorder.
After exercise, your heart rate remains at 120.
You can take nitroglycerin and Xanax.
Your heart rate may occasionally speed up or slow down, which is considered benign arrhythmia and does not require further treatment.
There's no need to worry.
Changhua Hospital cares about you.

Reply Date: 2017/06/11

More Info

Left chest pain, especially when associated with feelings of weakness and discomfort in the left arm, can be concerning and warrants careful evaluation. Given your history of mitral valve prolapse (MVP) and episodes of tachycardia, it is understandable that you are worried about the potential implications of these symptoms.

Mitral valve prolapse is a condition where the mitral valve does not close properly, which can lead to various symptoms, including palpitations, chest pain, and sometimes anxiety. While many individuals with MVP experience no significant issues, some may have symptoms that can be distressing. The symptoms you describe, such as the feeling of heaviness or weakness in the left chest and arm, could be related to MVP, especially if they occur during episodes of rapid heart rate. However, it is essential to consider other potential causes as well.

Your symptoms of left chest discomfort occurring spontaneously, especially during periods of rest or minimal activity, could also be linked to anxiety or panic attacks. Anxiety can manifest physically, leading to sensations of tightness in the chest, increased heart rate, and feelings of weakness. It is not uncommon for individuals who are prone to anxiety to experience these symptoms, particularly when they are under stress or feeling overwhelmed.

Regarding your question about the use of nitroglycerin and Xanax during episodes of chest pain, it is crucial to approach this with caution. Nitroglycerin is typically used to relieve angina (chest pain due to heart-related issues) and should only be taken if prescribed by a healthcare provider. If you experience chest pain that feels severe or is accompanied by other concerning symptoms (such as shortness of breath, sweating, or nausea), it is essential to seek immediate medical attention rather than self-medicating.

As for Xanax, it is a medication used to manage anxiety and panic disorders. If your healthcare provider has prescribed it for your anxiety, it may help alleviate some of the symptoms you are experiencing. However, it is essential to follow your doctor's guidance regarding its use, especially in conjunction with other medications.

The irregularities in your heart rate, such as occasionally feeling a beat that is faster or slower than usual, can also be a normal variant, especially in younger individuals. However, if these irregularities are frequent or associated with other symptoms, further evaluation may be warranted. A thorough assessment by a cardiologist, including an echocardiogram and possibly a Holter monitor (24-hour ECG), can help determine if there are any underlying issues that need to be addressed.

In summary, while your symptoms could be related to mitral valve prolapse, they may also be influenced by anxiety or other factors. It is essential to communicate openly with your healthcare providers about your concerns and symptoms. They can help you navigate the appropriate diagnostic tests and treatment options to ensure your well-being. If your symptoms persist or worsen, do not hesitate to seek further evaluation, as it is always better to err on the side of caution when it comes to heart health.

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