Autonomic Nervous System Disorders and Mitral Valve Prolapse

Autonomic nervous system dysfunction, mitral valve prolapse (regurgitation)?

Hello, Doctor.
I apologize for bothering you.
I usually do not drink alcohol, but in mid-November last year, I drank a lot and different types of alcohol during a social event.
Two days later, I caught a cold.
That night, I experienced what I believe was palpitations.
Since I had never experienced palpitations before, I became very anxious and quickly got up, but my heart rate shot up, likely exceeding 150 beats per minute for several minutes.
I called an ambulance to the hospital, but the doctor found everything normal (there is no family history of cardiovascular disease).
I later consulted several traditional Chinese medicine doctors, who suggested that it might be due to autonomic nervous system dysregulation, with symptoms fluctuating.
My resting heart rate is usually around 75-85 bpm, but when I change positions, my heart rate can quickly rise to 90-110 bpm, and I easily become anxious.
Recently, I experienced chest tightness and shortness of breath, but this improved after taking herbal medicine.
At night or when my heart rate slows down, I often feel like I have missed beats (premature contractions?), and my heart rhythm can be slightly irregular.
However, I had a similar episode again, where I felt palpitations while trying to fall asleep and became anxious.
I quickly got up and moved around a lot, but this time it was not as severe as the first episode and lasted only about half a minute.
I went to the hospital for an examination and later brought the report to be interpreted at Beirong Hospital.
The doctor mentioned that I have mitral valve prolapse and advised me to take medication for observation, prescribing "Xinkangle." A 24-hour Holter monitor report was reviewed by the doctor (who is currently the director of Yangming Hospital), and he felt it was acceptable.

1.
I would like to ask if these symptoms could be related to the mitral valve and autonomic nervous system? Thank you very much.
Regarding the 24-hour Holter monitor report, I was very anxious and fearful that the results would be abnormal.

2.
In the report under the "Ventricular Events" section, the results are as follows:
- V ectopic beats: 342
- Couplets: Mono 0, Poly 0, Triplets 0, Isolated 0
- Bigeminy: 1
- Trigeminy: 1
- VT: 0
- NSVT: 0
- Salvo: 0
- IVR: 0
Are these results within an acceptable range? Thank you, Doctor, for mentioning that the missed beats could possibly be related to the mitral valve.

conley, 20~29 year old female. Ask Date: 2019/02/21

Dr. He Dongjin reply Cardiology

Hello, this could possibly be symptoms caused by mitral valve issues and autonomic nervous system effects.
Ectopic beats at a rate of 342 may lead to sensations of missed beats, which could be a result of mitral valve prolapse.
This outcome is within an acceptable range.
There's no need to worry.
Changhua Hospital cares about you.

Reply Date: 2019/02/21

More Info

Hello! Thank you for reaching out with your questions regarding autonomic nervous system disorders and mitral valve prolapse (MVP). It's understandable to feel concerned given your experiences, especially with symptoms like palpitations, anxiety, and irregular heartbeats. Let’s break down your situation and address your concerns.

Understanding Autonomic Nervous System Disorders:
The autonomic nervous system (ANS) regulates involuntary bodily functions, including heart rate, blood pressure, respiration, and digestion. When the ANS is not functioning properly, it can lead to a variety of symptoms, including palpitations, anxiety, and changes in heart rate with posture (orthostatic changes). In your case, the episodes of rapid heart rate (tachycardia) and feelings of anxiety may be linked to autonomic dysregulation, especially given your history of stress and the recent alcohol consumption, which can exacerbate these symptoms.

Mitral Valve Prolapse:
Mitral valve prolapse is a condition where the valve between the heart's left atrium and left ventricle does not close properly. This can lead to a variety of symptoms, including palpitations, chest discomfort, and sometimes anxiety. It is not uncommon for individuals with MVP to experience ectopic beats, which are extra heartbeats that can feel like a fluttering or skipped beat. Your report of "ventricular events" indicates that you have experienced some ectopic beats, which can be benign, especially in the context of MVP.

Connection Between MVP and Autonomic Dysfunction:
There is a recognized connection between MVP and autonomic nervous system dysfunction. Many patients with MVP report symptoms that can be attributed to both the mechanical aspects of the valve and the autonomic nervous system's response. For instance, the anxiety and palpitations you experience may be exacerbated by the physical sensations caused by MVP, leading to a cycle of anxiety and increased heart rate.

Regarding Your Ectopic Beats:
The results you provided indicate that you have experienced a number of ectopic beats, with some bigeminy (alternating normal and ectopic beats) and trigeminy (two normal beats followed by one ectopic beat). While these findings can be concerning, they are often considered benign in the absence of underlying heart disease, especially in young individuals without a significant family history of cardiovascular issues. Your healthcare provider's reassurance after reviewing your 24-hour Holter monitor results is a positive sign.

Managing Your Symptoms:
1. Lifestyle Modifications: Reducing caffeine, managing stress through relaxation techniques (like yoga or meditation), and ensuring adequate hydration can help manage symptoms.

2. Regular Follow-ups: Continue to follow up with your healthcare provider to monitor your symptoms and heart health. If your symptoms worsen or if you have new concerns, don’t hesitate to seek further evaluation.

3. Medication: If your symptoms are significantly impacting your quality of life, discussing medication options with your doctor may be beneficial. Medications can help manage anxiety and palpitations.

In summary, your symptoms may indeed be related to both mitral valve prolapse and autonomic nervous system dysfunction. It’s essential to maintain open communication with your healthcare provider and to follow their recommendations for monitoring and managing your condition. Remember, many individuals with MVP lead normal, active lives, and with appropriate management, you can also find relief from your symptoms. If you have further questions or concerns, please feel free to ask!

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