Heart Palpitations During Exercise: Is It Related to Mitral Valve Prolapse?

Irregular heartbeats during exercise?

Hello, doctor.
Last year, I experienced chest tightness, heart pain during exercise, and occasional sharp pain, which led to a diagnosis of mitral valve prolapse.
However, the doctor said not to worry and prescribed medication, and after that, I didn't have many issues.
But since then, I've had periods of feeling fine and periods of discomfort.
This week, I've noticed that during slightly intense activities like running up stairs or jumping, I feel a sensation of my heart pounding inside my body, and the rhythm doesn't align with my heartbeat; they feel like they are separate.
Just now, after walking upstairs and lying down on the bed, I experienced this sensation again, where I felt about 5 to 6 rapid beats in the area of the left atrium over 2 seconds, almost like twitching, accompanied by a continuous noise, but my breathing feels fine.
My left chest still feels tight, and I want to know if this is related to my mitral valve prolapse.
What could be causing this? I trust the professional judgment of the doctors I've seen, but I'm still a bit scared...
Thank you for your patient response, and I appreciate your hard work!

Niming, 20~29 year old female. Ask Date: 2021/02/12

Dr. He Dongjin reply Cardiology

Hello, it may be related to mitral valve prolapse or some slight arrhythmia.
You should discuss this with your physician and consider scheduling a 24-hour Holter monitor test.
Changhua Hospital cares about you.

Reply Date: 2021/02/12

More Info

Heart palpitations during exercise can be concerning, especially for individuals diagnosed with mitral valve prolapse (MVP). MVP is a condition where the mitral valve doesn't close properly, which can lead to various symptoms, including palpitations, chest pain, and feelings of anxiety. Your experience of feeling your heart "jumping" or beating out of rhythm, particularly during physical exertion, is not uncommon among those with MVP.

The sensations you describe—such as the heart feeling like it is beating irregularly or out of sync—could be attributed to several factors related to MVP. When the heart is under stress from exercise, it can trigger premature contractions, known as premature atrial contractions (PACs) or premature ventricular contractions (PVCs). These can create the sensation of a "skipped beat" or an irregular heartbeat. In your case, the fact that these sensations occur during physical activity, such as running up stairs or jumping, suggests that your heart is responding to the increased demand for blood flow and oxygen during exercise.

Additionally, the left chest discomfort you are experiencing could be related to the increased workload on your heart during exercise. While MVP itself is often benign, it can sometimes be associated with other conditions, such as mitral regurgitation, which can exacerbate symptoms during physical activity. The "jumping" sensation you feel might also be linked to anxiety or stress, which can be heightened during exercise, especially if you are already concerned about your heart health.

It's important to note that while MVP is generally not a cause for alarm, the presence of symptoms like chest pain or significant palpitations warrants further evaluation. Your healthcare provider may recommend additional tests, such as an echocardiogram or a Holter monitor, to assess the function of your heart and the severity of the valve prolapse. These tests can help determine if there are any underlying issues that need to be addressed.

In terms of exercise, it is crucial to listen to your body. If you experience palpitations or discomfort, it may be wise to modify your exercise routine. Engaging in moderate, low-impact activities such as walking, swimming, or cycling can be beneficial without placing excessive strain on your heart. It's also advisable to avoid high-intensity workouts until you have a clearer understanding of your heart's condition.

Ultimately, while MVP can lead to palpitations and discomfort, it is essential to work closely with your healthcare provider to monitor your symptoms and adjust your exercise regimen accordingly. If your symptoms persist or worsen, seeking further evaluation is crucial to ensure your heart health is managed effectively. Remember, your well-being is the priority, and addressing any concerns with your healthcare provider will help you navigate your symptoms safely.

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