Mitral Valve Regurgitation: Symptoms and Concerns

Mitral valve insufficiency issue?

Hello Dr.
Wu, about a year and a half ago, I had an echocardiogram at the hospital and was diagnosed with mild mitral and aortic valve regurgitation and autonomic nervous system dysfunction.
However, recently I have been feeling unwell, experiencing increased anxiety, dizziness, and shortness of breath.
Additionally, my resting heart rate on my Apple Watch has decreased from 75 to 71, 70, and now to 69.
Therefore, I would like to ask the doctor: 1) Is it possible for the condition to progress from mild to severe regurgitation in a year and a half? 2) Could the decrease in heart rate, anxiety, and dizziness be due to worsening autonomic nervous system dysfunction caused by late-night sleeping habits?

Niming, 10~19 year old female. Ask Date: 2021/09/19

Dr. Wu Xueming reply Cardiology

1.
The likelihood of mild mitral valve prolapse progressing to severe is very low.
2.
Many factors in daily life can contribute to this condition, such as emotions, stress, and irregular routines.
It is recommended to adjust your lifestyle and engage in regular exercise.
However, if symptoms persist, it is advisable to seek further evaluation at a hospital.

Reply Date: 2021/09/19

More Info

Mitral valve regurgitation (MVR) is a condition where the mitral valve does not close properly, allowing blood to flow backward into the left atrium when the left ventricle contracts. This can lead to various symptoms and concerns, especially if the condition progresses from mild to moderate or severe.
1. Progression from Mild to Severe Regurgitation: It is indeed possible for mitral valve regurgitation to progress from mild to moderate or even severe over a period of a year and a half. The progression can be influenced by several factors, including the underlying cause of the regurgitation, the presence of other heart conditions, and individual patient factors such as age, lifestyle, and overall health. For instance, if the regurgitation is due to degenerative changes in the valve (like mitral valve prolapse), it may worsen over time. Regular follow-up with echocardiograms is essential to monitor the condition, as changes in the severity of regurgitation can occur without significant symptoms initially.

2. Symptoms of Anxiety, Dizziness, and Heart Rate Changes: The symptoms you are experiencing—such as increased anxiety, dizziness, and changes in resting heart rate—could indeed be related to autonomic nervous system dysregulation, which you mentioned. The autonomic nervous system controls involuntary bodily functions, including heart rate and blood pressure. Stress, anxiety, and poor sleep can exacerbate these symptoms, leading to a slower heart rate in some individuals. However, it is crucial to differentiate whether these symptoms are solely due to anxiety or if they are related to worsening cardiac function.
In patients with mitral valve regurgitation, especially if it progresses, symptoms can include fatigue, shortness of breath (especially during exertion), palpitations, and in some cases, chest pain. If the heart is unable to compensate for the regurgitation, it may lead to heart failure symptoms, which could explain your feelings of dizziness and breathlessness.
Given your concerns, it is advisable to consult your cardiologist for a thorough evaluation. They may recommend a repeat echocardiogram to assess the current status of your mitral valve and any changes in the left atrium or left ventricle size and function. Additionally, they can evaluate your symptoms in the context of your heart health and determine if further intervention is necessary.
In summary, while it is possible for mild mitral regurgitation to progress, the symptoms you are experiencing could be multifactorial. A comprehensive assessment by your healthcare provider will help clarify the situation and guide appropriate management. Regular monitoring and open communication with your healthcare team are key to managing your condition effectively.

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