Mitral Valve Insufficiency: Panic Attacks and Heart Health

Regarding valve insufficiency?

Dear Dr.
He,
About seven years ago, at the end of 2012, I experienced sudden shortness of breath at night.
After visiting the emergency room, my condition improved, and an electrocardiogram (ECG) performed there showed no abnormalities.
A few days later, to be cautious, I went to a medical facility equipped with Doppler sonography for a cardiac color ultrasound examination.
The physician first conducted a cardiac auscultation and an ECG, both of which were normal.
Subsequently, the echocardiogram was performed, and the results indicated that the size, function, and rhythm of my heart were all normal, with no evidence of valve prolapse.
However, it was noted that the mitral valve had a slight insufficiency (as I understood it).
The physician described the valve insufficiency as "very mild," even less than "mild," and ultimately concluded that my sudden shortness of breath was not related to my heart.
Later, I learned that it might have been caused by a panic attack or autonomic nervous system dysregulation.
I would like to ask Dr.
He the following questions:
1.
Given that my heart size, function, and rhythm are all normal and there is no valve prolapse, could the "very mild" mitral valve insufficiency have been caused by my panic attack or autonomic nervous system dysregulation, based on your experience and opinion?
2.
Following up on the above, if my panic disorder or autonomic nervous system dysregulation improves and resolves, will the mitral valve insufficiency also disappear and return to normal?
Thank you, Dr.
He.

A-Xiang, 30~39 year old female. Ask Date: 2019/10/27

Dr. He Dongjin reply Cardiology

Hello, almost everyone has some degree of regurgitation, whether mild or severe.
Mild mitral valve regurgitation is, in my opinion, not a cause for concern.
It is not related to panic disorder or autonomic nervous system dysregulation, and it is not caused by a panic attack at that moment.
Please do not worry; Changhua Hospital cares about you.

Reply Date: 2019/10/27

More Info

Mitral valve insufficiency, also known as mitral regurgitation, occurs when the mitral valve does not close tightly, allowing blood to flow backward into the left atrium when the left ventricle contracts. This condition can vary in severity and is often classified as mild, moderate, or severe. In your case, the assessment indicated that the mitral valve insufficiency is "very mild," which is a reassuring finding, especially in the context of normal heart size, function, and rhythm.

1. Connection Between Panic Attacks and Mitral Valve Insufficiency: It is important to understand that panic attacks and anxiety disorders can manifest with physical symptoms that may mimic cardiac issues, such as shortness of breath, palpitations, and chest discomfort. While panic attacks can lead to transient changes in heart function due to increased sympathetic nervous system activity, they do not directly cause structural heart problems like mitral valve insufficiency. However, anxiety can exacerbate the perception of existing heart conditions. In your case, the mild mitral regurgitation observed during the echocardiogram is likely a separate issue from your panic attacks. It is not uncommon for individuals with anxiety disorders to experience heightened awareness of bodily sensations, which can lead to misinterpretation of normal physiological responses as pathological.

2. Potential for Improvement with Anxiety Management: If your panic attacks and autonomic nervous system dysregulation improve, it is possible that your perception of symptoms related to the mitral valve insufficiency may also improve. However, the structural aspect of the mitral valve itself is unlikely to change significantly. Mild mitral regurgitation can often remain stable over time, especially if there are no other underlying heart conditions. In many cases, individuals with mild mitral regurgitation can lead normal, healthy lives without any significant limitations. Regular follow-up with a cardiologist is recommended to monitor the condition, especially if symptoms change or worsen.

In summary, while your panic attacks may not directly cause mitral valve insufficiency, they can influence your perception of symptoms. Addressing anxiety through therapy, lifestyle changes, or medication can improve your overall well-being and may help you feel more in control of your symptoms. It is essential to maintain open communication with your healthcare provider about both your cardiac health and mental health, as both aspects are crucial for your overall health and quality of life. Regular check-ups and echocardiograms can help ensure that your heart remains healthy and that any changes in your condition are promptly addressed.

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