Managing Mitral Valve Prolapse and Aortic Regurgitation: Treatment Options

Mitral valve prolapse, aortic valve insufficiency, and mitral and tricuspid valve regurgitation?

Hello Doctor: I have been experiencing chest pain and intermittent pain on the left side of my heart.
After a check-up with a cardiologist, I was diagnosed with mild mitral valve prolapse with regurgitation and autonomic nervous system dysfunction.
I was prescribed Concor 1.25 mg and Zanaflex 0.5 mg, taking one Concor in the morning and one Zanaflex in the morning and evening.
I have been on this medication for about three weeks.
Initially, I experienced skipped heartbeats or occasional palpitations daily, but there has been some improvement.
However, I still experience chest pain and left-sided heart pain every day.
During my follow-up visit, the doctor mentioned that these symptoms might persist.
I would like to ask if Concor is the only medication available for treating regurgitation, as I am concerned that the dosage may not be sufficient, but the doctor is unwilling to increase my medication.
Is it possible that I need to be on the medication for a while before it stabilizes? Are there any other medications available for treating mitral valve prolapse with regurgitation? I would appreciate your guidance.
Thank you.

maggie, 30~39 year old female. Ask Date: 2020/10/09

Dr. He Dongjin reply Cardiology

Hello, Kang Ken 1.25 and Zanano 0.5 are primarily used to treat mild autonomic nervous system disorders associated with mitral valve prolapse and regurgitation.
Generally, observation is sufficient, and no treatment is necessary.
You can try taking Kang Ken 1.25, one tablet in the morning and one in the evening, and once stabilized, you can adjust back to your original dosage of one tablet in the morning.
Don't worry; it's common to experience some discomfort during seasonal changes, and there are no other medications specifically for this condition.
Changhua Hospital cares about your well-being.

Reply Date: 2020/10/09

More Info

Managing mitral valve prolapse (MVP) and aortic regurgitation (AR) can be complex, especially when symptoms such as chest pain and palpitations are present. Your situation involves a diagnosis of mild mitral valve prolapse with regurgitation, along with autonomic nervous system dysregulation, which can contribute to your symptoms.

Treatment Options
1. Medication Management:
- The medications you are currently taking, such as Concor (Bisoprolol) and Zantac (Ranitidine), are typically used to manage symptoms associated with MVP and AR. Bisoprolol is a beta-blocker that can help reduce heart rate and alleviate symptoms like palpitations and chest pain. However, it may take time for the full effects to manifest, and some patients may require adjustments in dosage or additional medications.

- If your symptoms persist despite the current regimen, it is essential to communicate this to your healthcare provider. They may consider increasing the dosage of your current medications or adding other medications such as calcium channel blockers or additional beta-blockers, depending on your specific symptoms and overall health status.

2. Lifestyle Modifications:
- In addition to medication, lifestyle changes can significantly impact your symptoms. Regular aerobic exercise, a heart-healthy diet, and stress management techniques (like yoga or meditation) can help improve your overall cardiovascular health and potentially reduce symptoms.

3. Monitoring and Follow-Up:
- Regular follow-up appointments with your cardiologist are crucial. They can monitor the progression of your valve conditions through echocardiograms and other diagnostic tests. If your symptoms worsen or if there are significant changes in your heart function, more aggressive interventions may be warranted.

4. Surgical Options:
- In cases where mitral regurgitation becomes moderate to severe, or if there is significant left ventricular dilation or dysfunction, surgical intervention may be necessary. This could involve mitral valve repair or replacement. However, this is typically reserved for more advanced cases where medical management is no longer effective.

5. Consideration of Other Conditions:
- Since you mentioned autonomic dysfunction, it may be beneficial to explore this aspect further. Conditions affecting the autonomic nervous system can exacerbate symptoms of MVP and AR. Consulting with a specialist in autonomic disorders may provide additional insights and treatment options.

Conclusion
In summary, while your current medications are a good starting point, it is essential to maintain open communication with your healthcare provider regarding your ongoing symptoms. They can help determine if adjustments to your treatment plan are necessary. Additionally, lifestyle modifications and regular monitoring will play a crucial role in managing your condition effectively. If surgical options are ever considered, your cardiologist will guide you through the decision-making process based on the severity of your condition and your overall health. Always remember that managing heart conditions is a collaborative effort between you and your healthcare team.

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