Heart Valve Prolapse and Its Connection to Anxiety and Pain

Skin pain, chest pain, lower back pain?

Hello, Doctor.
Last year, I experienced fainting twice around my menstrual period.
After undergoing an electrocardiogram, echocardiogram, and 24-hour Holter monitoring, I was diagnosed with mitral valve prolapse, along with anxiety and autonomic nervous system dysregulation.
After adjusting my daily routine, I saw significant improvement, but recently, after my schedule was disrupted, I began experiencing insomnia, anxiety, palpitations, and random tingling in various areas such as my chest, back, arms, palms, thighs, and calves.
My fingers have slight swelling and numbness, and I also have stiffness and pain in my tailbone (lower back), which doesn't prevent me from bending but causes discomfort when I get up or exert myself.
I would like to inquire about the following: 1.
Are the issues mentioned related to my menstrual cycle (as it seems to occur during this time, and I also experience diarrhea)? 2.
Currently, I am experiencing cold symptoms (sore throat, nasal congestion, thick phlegm), but I am concerned it might be endocarditis or myocarditis.
3.
I notice that my palpitations often ease significantly after using the restroom; what could be the connection? 4.
I have experienced brief sharp pains in my left shoulder, left upper back, left armpit, and left side of my back.
I am unsure if this is due to autonomic nervous system dysregulation, neuropathic pain, or a precursor to a myocardial infarction.
Which specialist should I see first? Thank you, Doctor, for taking the time to respond!

J LEE, 20~29 year old female. Ask Date: 2021/05/08

Dr. He Dongjin reply Cardiology

Hello, it may be related to your menstrual cycle.
Changes in the menstrual cycle can also cause variations in the autonomic nervous system.
Endocarditis and myocarditis are not easily contracted, so try not to overthink it.
However, a cold can also lead to changes in the autonomic nervous system.
Going to the bathroom may help to soothe the autonomic nervous system a bit.
The brief sharp pain still seems like autonomic nervous system dysregulation rather than a myocardial infarction.
Just observe for now and don’t worry.
Changhua Hospital cares about you.

Reply Date: 2021/05/08

More Info

Understanding heart valve prolapse, particularly mitral valve prolapse (MVP), and its connection to anxiety and pain is crucial for managing symptoms and improving quality of life. MVP is a condition where the mitral valve, located between the left atrium and left ventricle of the heart, does not close properly, leading to potential regurgitation of blood. While many individuals with MVP experience no symptoms, others may suffer from a range of issues, including chest pain, palpitations, and anxiety.

Connection Between MVP and Anxiety
The relationship between MVP and anxiety is well-documented. Many patients with MVP report heightened levels of anxiety and panic attacks. This is thought to be due to the autonomic nervous system's response to the heart's irregularities. When the heart does not function optimally, it can trigger a fight-or-flight response, leading to increased heart rate, sweating, and feelings of panic. This cycle can exacerbate symptoms of anxiety, creating a feedback loop where anxiety leads to more pronounced physical symptoms, which in turn increases anxiety.

Symptoms and Their Management
Your symptoms, including palpitations, chest pain, and various body aches, can indeed be linked to MVP and anxiety. The fact that you experienced these symptoms around your menstrual cycle may suggest a hormonal influence, as hormonal fluctuations can impact both anxiety levels and the perception of pain. Additionally, the physical stress of menstruation, including cramping and gastrointestinal disturbances, could contribute to your overall discomfort.

The presence of symptoms such as tingling, numbness, and mild swelling in your fingers may also be related to anxiety and hyperventilation, which can occur during panic attacks. It is essential to differentiate between symptoms that are purely anxiety-related and those that may indicate a more serious condition.

Concerns About Heart Conditions
Your concerns regarding endocarditis or myocarditis, especially during a period of illness with symptoms like sore throat and nasal congestion, are valid. However, these conditions typically present with more severe symptoms, including high fever, significant fatigue, and more pronounced chest pain. If you have had thorough cardiac evaluations (like echocardiograms and EKGs) that show no significant abnormalities, the likelihood of these serious conditions is lower. Nevertheless, if you experience new or worsening symptoms, it is always prudent to seek medical attention.

Recommendations
1. Consultation with a Specialist: Given your symptoms, it would be beneficial to consult a cardiologist to discuss your MVP and any potential treatment options. They can provide reassurance and possibly recommend further testing if necessary.

2. Mental Health Support: Since anxiety plays a significant role in your symptoms, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can help manage anxiety and its physical manifestations.

3. Lifestyle Modifications: Maintaining a regular sleep schedule, engaging in relaxation techniques (such as yoga or meditation), and avoiding stimulants (like caffeine) can help reduce anxiety and improve your overall well-being.

4. Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare provider in tailoring a management plan.

5. Physical Activity: Regular, moderate exercise can help alleviate anxiety and improve cardiovascular health. However, listen to your body and avoid overexertion, especially if you experience chest pain or palpitations during physical activity.

6. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary. If your symptoms persist or worsen, do not hesitate to seek immediate medical attention.

In conclusion, while MVP can be associated with anxiety and various physical symptoms, most individuals can manage their condition effectively with appropriate medical care and lifestyle adjustments. It is essential to maintain open communication with your healthcare providers to ensure that all aspects of your health are addressed.

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