Mitral Valve Prolapse and Anxiety-Related Blood Pressure Issues

Mitral valve prolapse and autonomic nervous system dysfunction issues?

Hello Doctor, I would like to ask a few questions.

1.
Since I have an anxiety predisposition, I often monitor my blood pressure.
In the past, I used to measure it almost every day, and it typically ranges from the 140s with a heart rate of 90, eventually dropping to the 120s with a heart rate around 70 after a while.
I would like to know if this indicates that I do not have hypertension.
The cardiologist I visited advised me not to worry too much, as both the electrocardiogram and echocardiogram showed no structural issues, and I do not have hyperthyroidism.
2.
Given my anxiety, my blood pressure tends to rise when I visit the clinic.
Will prolonged periods of elevated blood pressure due to anxiety have any adverse effects on my health over time?
3.
I have mitral valve prolapse, and I would like to know if this condition could cause my heartbeat and carotid pulse to feel stronger than usual.
Sometimes, when I take a nap or lie down, I can feel my heart beating, which increases my anxiety and makes me feel like there is something wrong with my body, further affecting my sleep.
Although I practice diaphragmatic breathing to alleviate my anxiety, I still seem to be overly concerned about my health.
Thank you, Doctor, and I apologize for bothering you!

Mr. Chen, 20~29 year old female. Ask Date: 2020/04/24

Dr. He Dongjin reply Cardiology

Hello, anxiety and high blood pressure for a prolonged period can affect your body, so don't worry.
Try to focus your attention elsewhere.
You don't have high blood pressure, so there's no need to measure it.
Ping An Changhua Hospital cares about you.

Reply Date: 2020/04/24

More Info

Mitral Valve Prolapse (MVP) is a condition where one or both of the mitral valve leaflets bulge (prolapse) into the left atrium during the heart's contraction. While MVP is often benign and does not lead to significant health issues for many individuals, it can be associated with various symptoms, including palpitations, anxiety, and even changes in blood pressure.

1. Blood Pressure Concerns
From your description, it appears that you experience fluctuations in your blood pressure, particularly when you are anxious. Blood pressure readings of 140/90 mmHg (14x) indicate stage 1 hypertension, while readings of 120/70 mmHg (12x) are considered normal. It is important to note that anxiety can lead to temporary spikes in blood pressure, a phenomenon known as "white coat syndrome," where patients exhibit elevated blood pressure in clinical settings due to anxiety about being evaluated.
Since your heart ultrasound and electrocardiogram (ECG) show no structural issues, and you do not have hyperthyroidism, it is likely that your blood pressure fluctuations are primarily related to anxiety rather than a chronic hypertensive condition. Continuous monitoring and managing your anxiety can help stabilize your blood pressure readings.

2. Impact of Chronic Anxiety on Blood Pressure
Chronic anxiety can indeed have physiological effects on the body, including the cardiovascular system. When you are anxious, your body releases stress hormones like adrenaline, which can increase heart rate and blood pressure. While occasional spikes in blood pressure due to anxiety are generally not harmful, prolonged periods of elevated blood pressure can lead to cardiovascular issues over time.
To mitigate these effects, it is crucial to manage your anxiety effectively. Techniques such as cognitive behavioral therapy (CBT), mindfulness, and relaxation exercises (like the abdominal breathing technique you mentioned) can be beneficial. Regular physical activity, a balanced diet, and adequate sleep are also essential for overall cardiovascular health.

3. Mitral Valve Prolapse and Heart Sensations
Regarding your concern about feeling your heart beating strongly, especially when lying down or resting, this can be related to MVP. Some individuals with MVP report palpitations or a sensation of a racing heart, which can be exacerbated by anxiety. The feeling of a strong heartbeat in the neck (carotid pulse) can also be more pronounced in individuals with MVP due to the way the heart contracts and the dynamics of blood flow.

While MVP can cause these sensations, it is important to remember that they are often benign. However, if you experience significant discomfort, persistent palpitations, or other concerning symptoms, it is advisable to discuss these with your healthcare provider. They may recommend further evaluation or adjustments to your anxiety management strategies.

Conclusion
In summary, while your blood pressure readings and heart sensations can be concerning, they are likely influenced by your anxiety and the benign nature of your MVP. It is essential to continue monitoring your blood pressure and managing your anxiety through various techniques. Regular follow-ups with your healthcare provider will help ensure that any potential issues are addressed promptly. Remember, focusing on your overall well-being and employing stress-reduction techniques can significantly improve your quality of life.

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