Can Early Surgery for Mitral Valve Prolapse Restore Athletic Performance?

Can mitral valve prolapse surgery expedite the recovery of physical activity?

Hello, doctor! I am a tall and slender male.
Over three months ago, an echocardiogram revealed "mitral valve prolapse with mild regurgitation." I am a boxer and engage in intense exercise daily.
Recently, over the past month, I have started experiencing chest tightness, shortness of breath, and dizziness during exercise, which have been progressively worsening.
When lying flat to sleep, it feels like there is a heavy weight on my chest.
During my last visit, the doctor prescribed Inderal to alleviate the symptoms and advised me to avoid intense exercise, heavy lifting, and any impacts to the chest.
However, this sport is almost the meaning of my life, and I am only 23 years old.
I would like to ask:
1.
I have read on some English websites that only severe mitral regurgitation or impaired cardiac contractility qualifies for mitral valve repair surgery.
Is it possible to have surgery earlier, before the mitral condition worsens, based on symptoms or personal factors, even with mild regurgitation?
2.
After repair, is it possible to return to normal heart function, or will my exercise capacity be diminished permanently? Does earlier surgery lead to earlier deterioration, similar to valve replacement?
3.
If surgery is ultimately not an option, what compensatory methods can I pursue without giving up weight training and boxing? Thank you for your response!

Lin, 20~29 year old female. Ask Date: 2021/06/01

Dr. He Dongjin reply Cardiology

Hello, the symptoms may not necessarily be caused by mitral valve prolapse.
The mild regurgitation associated with mitral valve prolapse has likely been present for a long time; why have symptoms only appeared in the past month? It is possible that recent anxiety and overthinking have led to autonomic nervous system dysregulation.
It is uncommon to repair mild regurgitation; I have not heard of anyone doing that, and the effectiveness is unknown.
First, try to relax and start anew, gradually increasing your exercise intensity.
Take care from Changhua Hospital.

Reply Date: 2021/06/01

More Info

Mitral valve prolapse (MVP) is a condition where the valve between the heart's left atrium and left ventricle doesn't close properly, which can lead to mitral regurgitation (MR). In your case, you have been diagnosed with mild MR and are experiencing symptoms such as chest tightness, shortness of breath, and dizziness, especially during intense physical activity like boxing. These symptoms can be concerning, particularly for someone who is physically active and passionate about their sport.

1. Early Surgical Intervention: It is true that surgical intervention for mitral valve prolapse is typically indicated when there is significant mitral regurgitation or when the heart's function is compromised. However, in some cases, surgery may be considered earlier, especially if the patient is symptomatic and the symptoms are significantly affecting their quality of life or athletic performance. The decision to proceed with surgery is multifactorial and should involve a thorough evaluation by a cardiologist or a cardiac surgeon. They will consider your symptoms, the severity of the prolapse, the degree of regurgitation, and any potential risks associated with delaying surgery. If your symptoms are severe and impacting your ability to engage in your sport, discussing the possibility of early surgical intervention with your healthcare provider is warranted.

2. Post-Surgery Athletic Performance: Many patients who undergo mitral valve repair can return to their previous levels of physical activity, including high-intensity sports. The goal of surgery is to restore normal valve function, which can alleviate symptoms and improve overall heart function. While some individuals may experience a temporary decrease in athletic performance during recovery, most can regain their pre-surgery fitness levels with appropriate rehabilitation and a gradual return to exercise. It is essential to follow your surgeon's advice regarding the timeline for resuming physical activity and to engage in a structured rehabilitation program if recommended.

3. Alternative Management Strategies: If surgery is not pursued, managing your symptoms while continuing to engage in weight training and boxing can be challenging. It is crucial to follow your physician's advice regarding activity restrictions, especially concerning high-impact sports and activities that could put stress on your heart. You might consider modifying your training regimen to include lower-intensity activities that do not exacerbate your symptoms. Additionally, working with a sports medicine specialist or a physical therapist can help you develop a safe exercise plan that accommodates your condition while allowing you to maintain fitness.

In conclusion, while early surgery for mitral valve prolapse may be an option for you, it is essential to have an in-depth discussion with your healthcare provider about your symptoms, the potential benefits and risks of surgery, and how it may impact your athletic performance. With appropriate management, many individuals with MVP can continue to lead active lives and participate in sports. Always prioritize your health and safety, and do not hesitate to seek a second opinion if you feel uncertain about your treatment options.

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