Palpitations and Tricuspid Valve Prolapse: Causes and Concerns

Palpitations, tricuspid valve prolapse?

Hello, Doctor He: In the past year or two, I have frequently experienced a noticeable increase in my heart rate.
Although the values remain within the normal range, I never had this sensation before, and recently I have been feeling my heart beating strongly more often.
I recently underwent a health check-up, and the electrocardiogram results indicated that I might have premature ventricular contractions.
An echocardiogram showed that I have mild tricuspid valve prolapse, but it should not affect my daily life unless I am extremely fatigued.
I have also considered the possibility of autonomic nervous system dysfunction, but the test results for that were normal.
Since the palpitations and the sensation of strong heart contractions have become more pronounced and frequent, but the examination results do not indicate any major issues, I would like to ask the doctor what other potential causes could lead to these symptoms.
Should I undergo any additional tests? Thank you.

Xiao Mei, 30~39 year old female. Ask Date: 2019/04/13

Dr. He Dongjin reply Cardiology

Hello, the more you pay attention to it, the more noticeable the premature ventricular contractions (PVCs) become.
They are generally benign, and it's best to coexist with them peacefully.
If the symptoms become bothersome, some medications can help manage them.
Don't worry, they are not harmful.
Changhua Hospital cares about you.

Reply Date: 2019/04/13

More Info

Palpitations, or the sensation of feeling your heart beating rapidly or irregularly, can be concerning, especially when accompanied by other symptoms or changes in your health. In your case, you have reported experiencing noticeable palpitations over the past couple of years, along with a recent diagnosis of mild tricuspid valve prolapse and premature ventricular contractions (PVCs). Let's delve into the potential causes and concerns surrounding these symptoms.

Understanding Palpitations
Palpitations can arise from various factors, including:
1. Cardiac Causes: Conditions such as arrhythmias (like PVCs), valve disorders (like tricuspid valve prolapse), or structural heart issues can lead to palpitations. In your case, the PVCs and mild tricuspid valve prolapse may be contributing to your symptoms. Tricuspid valve prolapse is generally benign, especially if it is mild and not causing significant regurgitation or symptoms.

2. Non-Cardiac Causes: Stress, anxiety, caffeine intake, alcohol consumption, and certain medications can also lead to palpitations. Hormonal changes, such as those occurring during menstruation or menopause, can also play a role.

3. Autonomic Nervous System: Although your autonomic nervous system tests came back normal, dysregulation can still occur in subtle ways. The autonomic nervous system controls heart rate and can be influenced by stress, fatigue, and lifestyle factors.

Concerns with Tricuspid Valve Prolapse
Tricuspid valve prolapse is a condition where the valve does not close properly, which can lead to regurgitation. While mild cases are often asymptomatic and do not require treatment, they can sometimes be associated with palpitations. The key concerns include:
- Regurgitation: If the prolapse is significant, it can lead to blood leaking backward into the right atrium, potentially causing symptoms like fatigue, swelling, or palpitations.

- Arrhythmias: Some individuals with valve prolapse may experience arrhythmias, which can manifest as palpitations.

Next Steps and Recommendations
Given your symptoms and the findings from your tests, here are some recommendations:
1. Follow-Up with a Cardiologist: It's essential to have a thorough discussion with your cardiologist about your symptoms. They may recommend further evaluation, such as a Holter monitor (24-hour ECG) to capture any arrhythmias that may not have been present during your initial tests.

2. Lifestyle Modifications: Consider evaluating your lifestyle for potential triggers of palpitations. Reducing caffeine, managing stress through relaxation techniques, and ensuring adequate sleep can be beneficial.

3. Additional Testing: If your symptoms persist or worsen, further testing may be warranted. This could include echocardiography to assess the tricuspid valve function more closely, or even an exercise stress test to evaluate how your heart responds under physical exertion.

4. Monitoring Symptoms: Keep a diary of your palpitations, noting when they occur, their duration, and any associated symptoms (like dizziness or shortness of breath). This information can be valuable for your healthcare provider.

5. Consider Psychological Factors: If anxiety or stress is suspected to be a contributing factor, discussing this with a mental health professional may be beneficial.

Conclusion
While your current test results may not indicate a significant cardiac issue, the experience of palpitations can still be distressing and warrants further exploration. By working closely with your healthcare provider, you can develop a comprehensive plan to address your symptoms and ensure your heart health remains a priority. Remember, the goal is to understand the underlying causes of your palpitations and manage them effectively, allowing you to maintain a good quality of life.

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