Mitral and Tricuspid Valve Prolapse: Symptoms and Pregnancy Concerns

Q: Mitral and Tricuspid Valve Prolapse: Symptoms and Pregnancy Concerns

Hello： 1. After pregnancy, mitral valve prolapse may improve, but regurgitation may worsen slightly. 2. Mitral valve prolapse can also be considered a personal constitution; it is commonly seen in young women aged 20 to 30. 3. In daily life, it is

Mitral and tricuspid valve prolapse

Hello Doctor: Recently, I have been experiencing decreased physical stamina, shortness of breath, and chest tightness (feeling as if being pressed by a stone).
I also feel fatigued easily and cannot lie flat while sleeping; whenever I do, I feel uncomfortable and my chest becomes tighter.
This discomfort persists even when I sleep on my side.
Currently, I need to elevate myself slightly to sleep better.
After visiting the hospital for an examination, the doctor informed me that I have mitral and tricuspid valve prolapse with regurgitation, as well as some premature atrial contractions.
The doctor mentioned that my current condition is relatively normal and advised me to relax, but I need to have regular follow-ups every six months to a year, as I am planning to become pregnant.
Below are the results of my echocardiogram:
MMode/2D Measurements
- Aortic root: 23 mm
- LVIDd: 41 mm
- IVSd: 6 mm
- EDV (MOD-sp4): 33 ml
- LAD: 25 mm
- LVIDs: 28 mm
- LVPWd: 6 mm
- ESV (MOD-sp4): 14 ml
- LA Volume:
- LVEF (MOD-sp4): 58 %
Doppler and Color Doppler Measurements
- MV E: 69.1 cm/s
- E’_Med: 11.5 cm/s
- MR ERO:
- MV A: 36.0 cm/s
- E/E’_Med: 6.0
- MVA (P1/2t):
- MV dec time: 0.3 s
- E’_Lat:
- MV max PG:
- MV E/A: 1.9
- E/E’_Lat:
- MV mean PG:
- LV IVRT:
- AVA (I,D):
- TR Max PG: 21.8 mm
- CO (LVOT):
- Ao max PG:
- RVSP: 26.8 mm
- CO (PV):
- Ao mean PG:
- Qp/Qs:
- AI P1/2t:
Conclusion & Comments
1.
Normal aortic valve with no aortic regurgitation.
2.
Mitral valve prolapse, anterior leaflet with mild mitral regurgitation.
3.
Normal left ventricular size, wall thickness, and systolic function.
4.
No left ventricular segmental wall motion abnormalities.
5.
Normal left ventricular diastolic function.
6.
Tricuspid valve prolapse with mild to moderate tricuspid regurgitation.
7.
Normal pulmonary artery systolic pressure.
8.
Normal pulmonic valve with no regurgitation.
9.
Normal right ventricular size, wall thickness, and systolic function.
10.
Normal atrial size.
11.
No pericardial effusion.
Question 1: Will pregnancy worsen my symptoms?
Question 2: Since my university health check showed normal results with no mitral valve prolapse, what could have caused the prolapse to develop?
Question 3: Can I engage in daily activities without any special restrictions?
(Thank you, Doctor, for taking the time to answer my questions!)

Han, 30~39 year old female. Ask Date: 2017/11/03

Dr. Lin Jixiong reply Cardiology

Hello:
1.
After pregnancy, mitral valve prolapse may improve, but regurgitation may worsen slightly.

2.
Mitral valve prolapse can also be considered a personal constitution; it is commonly seen in young women aged 20 to 30.

3.
In daily life, it is important to pay attention to diet and avoid beverages high in caffeine, and to maintain a regular sleep schedule without staying up late.

Dr.
Lin Chi-Hsiung

Reply Date: 2017/11/03

More Info

Mitral and tricuspid valve prolapse (MVP and TVP) are conditions that can raise concerns during pregnancy, particularly due to the physiological changes that occur in a woman's body during this time. Understanding the implications of these conditions is crucial for managing both maternal and fetal health.

1. Will pregnancy worsen symptoms?
Pregnancy induces significant hemodynamic changes, including increased blood volume, cardiac output, and heart rate. For women with MVP or TVP, these changes can sometimes exacerbate symptoms such as palpitations, shortness of breath, and chest discomfort. However, many women with mild to moderate valve prolapse experience no significant worsening of symptoms during pregnancy. It's essential to monitor symptoms closely and maintain regular follow-ups with a healthcare provider. If symptoms such as severe shortness of breath, chest pain, or syncope occur, immediate medical attention is warranted.

2. What causes the development of prolapse?
Mitral valve prolapse can be a congenital condition, meaning it is present from birth. It may also develop over time due to factors such as connective tissue disorders (like Marfan syndrome), aging, or other heart conditions. The fact that you had a normal report during your university health check suggests that the prolapse may have developed later in life, possibly due to changes in your heart structure or function. Regular echocardiograms can help track any changes in your heart's condition, especially if you are planning to become pregnant.

3. Are there activity restrictions in daily life?
For most individuals with mild to moderate MVP or TVP, there are no strict limitations on daily activities. However, it is advisable to avoid extreme physical exertion or activities that may lead to excessive strain on the heart. Engaging in moderate exercise, such as walking or swimming, is generally beneficial and can help maintain cardiovascular health. It's crucial to listen to your body; if you experience increased fatigue, palpitations, or any other concerning symptoms during physical activity, you should consult your healthcare provider.

Additional Considerations:
- Monitoring: Regular follow-ups with a cardiologist or obstetrician specializing in high-risk pregnancies are essential. They can provide tailored advice based on your specific condition and monitor any changes throughout your pregnancy.

- Medication: If you are experiencing significant symptoms, your doctor may prescribe medications to help manage them. However, it's vital to discuss the safety of any medications during pregnancy.

- Delivery Planning: Depending on the severity of your valve prolapse and any associated symptoms, your healthcare team may recommend a specific delivery plan. In some cases, a vaginal delivery is possible, but if there are concerns about your heart's function, a cesarean section may be considered.

- Emotional Support: Pregnancy can be a stressful time, especially with underlying health concerns. Seeking support from family, friends, or a mental health professional can help manage anxiety related to your condition.

In conclusion, while mitral and tricuspid valve prolapse can present challenges during pregnancy, many women with these conditions have successful pregnancies and healthy babies. Close monitoring, a good support system, and open communication with your healthcare team are key to navigating this journey safely.

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