Mitral Valve Prolapse Symptoms: Breathing Issues Explained

Symptoms associated with mitral valve prolapse?

Hello Doctor, I recently visited a cardiologist due to issues with shortness of breath and difficulty taking deep breaths.
After performing an electrocardiogram and echocardiogram, the doctor informed me that I have mitral valve prolapse.
However, my symptoms only begin when I am sitting or standing, and as soon as I lie down, my breathing returns to normal within a short time.
My breathing is also normal while sleeping, which is contrary to typical heart problems where lying down worsens shortness of breath.
I would like to ask the doctor:
1.
Are there clinical cases similar to mine, where shortness of breath occurs while sitting or standing but improves when lying down? If so, what could be the possible reasons for this?
2.
I believe I have not been under much stress lately, so why would this lead to the onset of symptoms related to mitral valve prolapse? In the past, I only experienced palpitations when drinking coffee, but I have never had symptoms of shortness of breath like recently.
3.
My symptoms occur every afternoon to evening, but I have no issues in the morning.
What could be the reason for not being able to take deep breaths throughout the day? Generally, shouldn’t symptoms resolve after a short episode?
4.
Does having a hunched back or asthma exacerbate symptoms of mitral valve prolapse? I have a slight hunchback, and I also feel short of breath when I try to stand up straight.
I had a history of asthma in elementary school, but it has not flared up for a long time.

Wendy, 20~29 year old female. Ask Date: 2022/06/11

Dr. Wu Xueming reply Cardiology

1.
Are there clinical cases similar to mine where individuals experience difficulty breathing while sitting or standing, but find relief when lying down? If so, what could be the possible reasons? This symptom is quite rare.

2.
I believe I have not been under much stress recently, so why would this lead to the onset of mitral valve prolapse symptoms? In the past, I only experienced palpitations when drinking coffee, but I have never had symptoms of not being able to take a full breath like recently.
Lack of exercise and irregular sleep patterns could also contribute.
3.
My symptoms occur every afternoon to evening, but I have no issues in the morning.
Can you explain why I experience difficulty breathing throughout the day? Generally, shouldn't symptoms resolve after a brief episode? I will try to maintain a regular routine and exercise regularly.
4.
Can kyphosis or asthma worsen the symptoms of mitral valve prolapse? I have a slight hunchback, and I feel like I can't take a full breath when I straighten up.
I had a history of asthma in elementary school, but it has not flared up in a long time.
No, mitral valve prolapse is mostly mild and is not exacerbated by kyphosis or asthma.

Reply Date: 2022/06/11

More Info

Mitral Valve Prolapse (MVP) is a condition where the mitral valve does not close properly, which can lead to various symptoms, including breathing difficulties. Your situation, where you experience difficulty breathing while sitting or standing but find relief when lying down, is indeed interesting and not uncommon among individuals with MVP. Let's address your questions one by one.

1. Clinical Cases Similar to Yours: Yes, there are clinical cases where patients with MVP report experiencing shortness of breath or difficulty in breathing while sitting or standing, which improves upon lying down. This phenomenon can be attributed to several factors. When you are upright, gravity can affect the distribution of blood in your body, potentially leading to increased pressure in the lungs or heart. Additionally, anxiety or tension while sitting or standing may exacerbate the perception of breathlessness. Lying down can help redistribute blood flow and reduce the workload on the heart, thus alleviating the sensation of breathlessness.

2. Triggers for MVP Symptoms: MVP symptoms can sometimes be triggered by various factors, including stress, caffeine intake, and even hormonal changes. While you may not feel stressed, subtle stressors or changes in your body can provoke symptoms. Caffeine, for instance, can lead to increased heart rate or palpitations, which might explain your previous experiences of heart palpitations when consuming coffee. It’s also worth noting that MVP can be influenced by genetic factors, and symptoms can fluctuate over time, sometimes appearing without a clear trigger.

3. Daily Variation in Symptoms: The fact that your symptoms occur in the afternoon to evening but not in the morning could be related to several factors, including physical activity levels, hydration status, or even dietary choices throughout the day. As the day progresses, fatigue can set in, and if you are more active or anxious during the day, it could lead to increased symptoms. It’s also possible that your body’s response to daily stressors accumulates, leading to a heightened perception of breathlessness later in the day.

4. Impact of Posture and History of Asthma: Your mild kyphosis (hunchback) may indeed contribute to your symptoms. Poor posture can restrict lung expansion and lead to inefficient breathing patterns, which might explain why you feel short of breath when trying to sit up straight. Additionally, a history of asthma can make you more sensitive to changes in your respiratory function, even if you haven’t had an asthma attack in a long time. It’s essential to maintain good posture and consider breathing exercises that can help improve lung capacity and efficiency.

In summary, while your symptoms may seem atypical for a heart condition, they can be explained by the interplay of MVP, body posture, daily activities, and possibly even psychological factors. It’s crucial to continue monitoring your symptoms and maintain open communication with your healthcare provider. If your symptoms worsen or change significantly, further evaluation may be necessary to rule out other underlying conditions. Regular follow-ups and possibly a referral to a pulmonologist or a cardiologist specializing in MVP may provide additional insights and management strategies tailored to your needs.

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