Symptoms: Is It Muscle-Nerve Issues or Mitral Valve Prolapse?

#185281 Additional Questions and Symptoms

First of all, thank you very much for your response, Doctor.
I have a few questions regarding your reply.
First, can symptoms help determine whether the issue is related to a neuromuscular problem or is caused by mitral valve prolapse? Second, can mitral valve prolapse develop as an acquired condition? Lastly, I would like to provide additional details about my symptoms to assist you in making a diagnosis.
After my last inquiry, I experienced no abnormalities for about two days, but after a few days, I began to have pain again.
The duration of the pain remains inconsistent; a few days ago, it lasted about 30 minutes, but today it has lasted longer, approximately two hours.
The pain is not extremely severe, but the pain points are quite distinct: one is located about three fingerbreadths below the clavicle, and the other is where the left armpit connects to the chest.
Lightly massaging these areas provides slight relief, and raising my left arm to stretch also helps alleviate the pain somewhat, but neither method completely resolves the chest pain issue.
I appreciate your assistance in clarifying these concerns.
Thank you, Doctor.

Wayne, 20~29 year old female. Ask Date: 2022/08/20

Dr. He Dongjin reply Cardiology

Hello, first, it is not possible to determine solely from symptoms whether the issue is related to a neuromuscular problem or caused by mitral valve prolapse.
Second, mitral valve prolapse is often congenital but may not always present with symptoms.
Symptoms can arise due to autonomic nervous system instability or dysregulation, indicating that they may be acquired.
If the pain points are very specific and changes in posture provide relief, it leans more towards a neuromuscular issue.
In your case, I believe there may be both neuromuscular problems and mitral valve prolapse.
Peace and care from Changhua Hospital.

Reply Date: 2022/08/20

More Info

Understanding the distinction between muscle-nerve issues and mitral valve prolapse (MVP) is crucial for accurate diagnosis and treatment. Let's break down your questions and symptoms to provide clarity.

1. Differentiating Muscle-Nerve Issues from Mitral Valve Prolapse
The symptoms you describe, particularly the localized pain under the collarbone and in the left axillary region, suggest a musculoskeletal origin, possibly involving muscle strain or nerve compression. Muscle-nerve issues often present with pain that can be exacerbated by certain movements or positions, and may also be accompanied by sensations such as tingling or weakness in the affected area.
In contrast, mitral valve prolapse is a cardiac condition where the valve does not close properly, which can lead to symptoms such as palpitations, shortness of breath, or atypical chest pain. While MVP can cause chest discomfort, it typically does not present with localized pain that is relieved by movement or pressure, as you described.
To differentiate between the two, a thorough clinical evaluation is necessary, including a physical examination and possibly an echocardiogram to assess the mitral valve's function. If your symptoms are primarily musculoskeletal, they may not warrant cardiac evaluation unless other concerning symptoms arise.

2. Can Mitral Valve Prolapse Develop Later in Life?
Yes, mitral valve prolapse can develop later in life, although it is often a congenital condition. Factors such as connective tissue disorders, aging, or other cardiac conditions can contribute to the development of MVP. In some cases, it may be asymptomatic and only discovered incidentally during imaging studies for other reasons.

3. Understanding Your Symptoms
You mentioned experiencing pain that is not very intense but is localized and can be somewhat relieved by stretching or gentle pressure. This pattern is more consistent with musculoskeletal pain rather than cardiac pain. The fact that the pain is intermittent and varies in duration suggests that it may be related to muscle tension or nerve irritation, possibly due to posture or repetitive strain.

Recommendations for Further Evaluation
Given your symptoms, it would be advisable to consult with a healthcare provider who can perform a physical examination and possibly recommend imaging studies, such as X-rays or an MRI, to evaluate for any underlying musculoskeletal issues. Additionally, a referral to a physical therapist could be beneficial. They can provide exercises to strengthen the muscles around the shoulder and chest, improve posture, and alleviate pain.

Conclusion
In summary, while it is essential to consider all potential causes of your symptoms, the characteristics of your pain suggest a musculoskeletal issue rather than mitral valve prolapse. However, if you experience any new or worsening symptoms, such as significant shortness of breath, palpitations, or severe chest pain, it is crucial to seek immediate medical attention. Always communicate openly with your healthcare provider about your symptoms and concerns to ensure appropriate evaluation and management.

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