Mitral Valve Prolapse: Symptoms, Concerns, and Next Steps

Mitral valve prolapse

Hello doctor, I would like to ask about my previous experience with tremors.
I remember that in middle school, I had severe chest pain and was taken to the hospital for emergency care.
The doctor mentioned that I naturally have a faster heart rate, usually around 100 beats per minute.
I was previously tested for hyperthyroidism, but the results were negative.
I was then referred to a cardiologist, who diagnosed me with mitral valve prolapse.
The doctor said there was no need for concern, and I have been on medication for a long time, but I still occasionally experience sudden severe pain, cold sweats, or full-body tremors.

On March 30, 2019, I had sudden pain and full-body tremors (heart rate 120).
The next day, March 31, I experienced shortness of breath and difficulty breathing, with a rapid breathing pattern (heart rate 130).
Then on April 1, the same symptoms continued (heart rate 140).
Today, April 2, I sought medical attention due to severe shortness of breath, full-body shaking, and numbness in my face and hands, which caused chest pain from heavy breathing (heart rate 150).
The doctor said there was no issue, just that my heart was beating too fast, and prescribed medication.
After taking the medication, I felt better for about an hour, but then the shortness of breath returned.

This is the first time I have experienced so many symptoms consecutively, and I am worried that there may be more issues beyond the prolapse.
Would you recommend switching to another hospital or doctor? Or do you have any suggestions regarding this issue? I am very concerned! Thank you.

Celine, 20~29 year old female. Ask Date: 2019/04/02

Dr. He Dongjin reply Cardiology

Hello, you are experiencing hyperventilation syndrome and autonomic nervous system dysregulation.
It is recommended that you visit a psychosomatic medicine clinic for further evaluation and treatment.
Changhua Hospital cares about your well-being.

Reply Date: 2019/04/02

More Info

Mitral Valve Prolapse (MVP) is a condition where the mitral valve, which separates the left atrium from the left ventricle of the heart, does not close properly. This can lead to a variety of symptoms and concerns, particularly in individuals like yourself who have experienced significant episodes of chest pain, palpitations, and other distressing symptoms.

Understanding Mitral Valve Prolapse
MVP is often benign and may not require treatment if symptoms are mild or absent. However, in some cases, it can lead to complications such as mitral regurgitation (where blood leaks backward into the left atrium), arrhythmias (irregular heartbeats), and, in rare cases, endocarditis (infection of the heart lining). Symptoms associated with MVP can include:
- Palpitations or irregular heartbeats
- Chest pain or discomfort
- Shortness of breath, especially during physical activity
- Fatigue
- Anxiety or panic attacks

Your Symptoms and Concerns
Given your history of episodes characterized by severe chest pain, rapid heart rate, and shaking, it is understandable that you are concerned about the implications of MVP. The episodes of tachycardia (rapid heart rate) you described, along with the accompanying symptoms of cold sweats and difficulty breathing, warrant careful evaluation. While MVP can cause palpitations and anxiety, the severity of your symptoms suggests that further investigation is necessary to rule out other potential cardiac issues.

Next Steps
1. Consult a Cardiologist: If you have not already, consider seeking a second opinion from a cardiologist who specializes in valvular heart disease. They can provide a thorough evaluation, including echocardiography, to assess the severity of your MVP and any associated regurgitation.

2. Holter Monitor: A Holter monitor can be useful to capture your heart's rhythm over 24-48 hours. This can help identify any arrhythmias that may be contributing to your symptoms.

3. Stress Testing: A cardiac stress test can evaluate how your heart functions under physical stress and may help identify any ischemic changes that could explain your symptoms.

4. Medication Review: Discuss your current medications with your healthcare provider. Sometimes, medications can help manage symptoms associated with MVP, such as beta-blockers for palpitations or anxiety.

5. Lifestyle Modifications: Consider lifestyle changes that may help manage your symptoms, such as reducing caffeine intake, practicing relaxation techniques, and engaging in regular, moderate exercise as tolerated.

6. Monitor Symptoms: Keep a detailed log of your symptoms, including their frequency, duration, and any potential triggers. This information can be invaluable for your healthcare provider in determining the best course of action.

Conclusion
While MVP can be concerning, many individuals live normal, healthy lives with this condition. However, your symptoms suggest that a more comprehensive evaluation is warranted to ensure there are no other underlying issues contributing to your distress. Do not hesitate to seek further medical advice and advocate for your health. It is essential to feel confident in your care and to have a healthcare team that addresses all your concerns. Remember, your health and peace of mind are paramount.

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