Breathlessness: Insights on Mitral Valve Prolapse and Dizziness

Feeling unable to breathe?

Hello Doctor, I have mitral valve prolapse and vertigo.
Whenever I am in a car, even with the air conditioning on, I must crack a window open; otherwise, I feel like I can't breathe, start to hyperventilate, feel nauseous, and then get a headache.
This issue is very troubling for me, and my friends cannot understand why I need to do this.
They think it's unnecessary to open a window when the air conditioning is on, and no matter how I explain it, they just can't accept or understand.
I would like to ask the doctor what might be causing this.

Su Wanting, 40~49 year old female. Ask Date: 2021/05/29

Dr. Hong Yuanbin reply Internal Medicine

Hello, regarding the breathing difficulties you mentioned, there could be many potential causes, including issues related to the heart, lungs, or psychological factors.
Simply relying on symptom description may not allow for a proper assessment.
It is recommended that you visit a pulmonology clinic for further evaluation of your lungs or heart.
Thank you for your inquiry.

Reply Date: 2021/05/29

More Info

Breathlessness, especially in the context of mitral valve prolapse (MVP) and dizziness, can be a complex issue that intertwines both physiological and psychological factors. Your experience of feeling breathless and anxious when the car windows are closed, even with the air conditioning on, is not uncommon among individuals with MVP and other anxiety-related conditions.
Mitral valve prolapse is a condition where the valve between the heart's left atrium and left ventricle does not close properly, which can lead to various symptoms, including palpitations, chest pain, and in some cases, anxiety or panic-like symptoms. While MVP is often benign and does not require treatment, it can be associated with autonomic nervous system dysregulation, which may contribute to feelings of breathlessness and dizziness.

The sensation of not being able to breathe properly in a closed environment, such as a car, can be attributed to several factors:
1. Psychological Factors: Anxiety and panic attacks can manifest as physical symptoms, including shortness of breath. The feeling of being trapped in a closed space can trigger anxiety, leading to hyperventilation or a sensation of air hunger. This is particularly relevant if you have a history of anxiety or panic disorders.

2. Autonomic Nervous System: MVP can affect the autonomic nervous system, which controls involuntary bodily functions, including heart rate and breathing. Dysregulation in this system can lead to symptoms like dizziness and breathlessness, especially in stressful situations.

3. Environmental Factors: Even with air conditioning, the air quality in a closed car can feel different compared to outside air. Some individuals are more sensitive to changes in air quality or temperature, which can exacerbate feelings of breathlessness.

4. Physical Response: When you feel anxious or panicked, your body may respond with a fight-or-flight response, leading to rapid breathing (hyperventilation), which can cause a decrease in carbon dioxide levels in the blood, resulting in dizziness and a feeling of breathlessness.

To address your concerns, here are some recommendations:
- Breathing Techniques: Practicing controlled breathing techniques can help manage feelings of breathlessness. Techniques such as diaphragmatic breathing or pursed-lip breathing can help regulate your breathing pattern and reduce anxiety.

- Cognitive Behavioral Therapy (CBT): If anxiety is a significant factor in your symptoms, consider seeking therapy. CBT can help you understand and manage your anxiety, providing tools to cope with situations that trigger your symptoms.

- Consult a Specialist: It may be beneficial to consult with a cardiologist familiar with MVP and a mental health professional to explore the interplay between your physical symptoms and anxiety. They can provide a comprehensive evaluation and tailored treatment plan.

- Gradual Exposure: If possible, gradually expose yourself to situations that trigger your symptoms in a controlled manner. This could help desensitize your response over time.

In summary, your symptoms of breathlessness and dizziness in a closed car environment may stem from a combination of physiological responses related to mitral valve prolapse and psychological factors such as anxiety. Understanding this interplay can empower you to seek appropriate interventions and support, ultimately improving your quality of life.

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