Mitral Valve Prolapse: Symptoms, Medications, and Risks

I would like to ask you about mitral valve prolapse?

First of all, thank you for your reply.
I truly appreciate your willingness to help someone you have never met! The medications my friend is taking are Vetrimil 40mg and Erispan.
She does not have mitral valve regurgitation or mitral valve thickening, but she experiences chest tightness, chest pain, and arrhythmia.
She does not take medication regularly, but sometimes she may take it once or twice a day, and the frequency increases during severe episodes.
I would like to ask you the following questions:
1.
What are these two medications? What are the potential side effects of long-term use, and what about short-term use?
2.
If she has simple mitral valve prolapse (but experiences chest tightness, chest pain, and arrhythmia), should she only focus on sleep, diet, and emotional well-being? Does this condition pose any significant risks for childbirth or lifespan?
3.
If it progresses to mitral valve regurgitation, what impact would that have on daily activities, lifespan, and childbirth?
4.
If it progresses to mitral valve thickening, what effects would that have on daily activities, lifespan, and childbirth?
5.
If she develops mitral valve regurgitation and complications such as infective endocarditis or impaired heart function, what would be the approximate cost of mitral valve replacement? Is the surgery risky? What are the potential postoperative complications? Is the mitral valve prosthetic or biological? If it is biological, will the surgery require waiting for a suitable donor, and how long might that take?
I am truly grateful for your expertise in clarifying these issues for me.
I am at a loss for how to express my gratitude, but I can only say: thank you! Thank you!

A-Liang, 20~29 year old female. Ask Date: 2003/11/20

Dr. Li Dong'an reply Internal Medicine

Hello A-Liang,
1.
Vetrimil is a calcium channel blocker, and possible side effects include bradycardia, hypotension, and constipation.
Erispan is a sedative, and its potential side effects include drowsiness, which should be avoided by pregnant women.
The occurrence of side effects may be related to individual constitution, so please take medications as prescribed by your physician.
2.
Given the symptoms you mentioned, please visit a cardiology outpatient clinic for an evaluation to determine if there are any underlying heart conditions.
The prognosis may vary depending on the presence of other heart diseases.
3.
Mitral valve prolapse with severe mitral regurgitation is treated similarly to severe mitral regurgitation.
If clinical evaluation indicates the need for surgical intervention, mitral valve repair or mitral valve replacement may be considered.
4.
Cardiac surgery carries inherent risks.
After replacing the mitral valve with a mechanical prosthesis, lifelong anticoagulation therapy is required, necessitating regular monitoring of coagulation function to prevent bleeding complications.
Bioprosthetic mitral valves may degenerate over time, requiring further replacement.
Bioprosthetic valves do not require a heart donor, whereas heart transplantation does require a donor heart.
If you have further questions regarding cardiac surgery, it is advisable to consult a cardiac surgeon.
Thank you.

Reply Date: 2003/11/20

More Info

Mitral valve prolapse (MVP) is a condition where the mitral valve does not close properly, which can lead to various symptoms and complications. Understanding the implications of MVP, especially in terms of symptoms, medications, and potential risks, is crucial for managing the condition effectively.

1. Medications: Vetrimil and Erispan
Vetrimil (likely referring to a medication containing Valsartan) is an angiotensin receptor blocker (ARB) used primarily for treating high blood pressure and heart failure. It helps relax blood vessels, making it easier for the heart to pump blood. Erispan (likely referring to a medication containing Escitalopram) is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class, often prescribed for anxiety and depression.

Side Effects:
- Long-term side effects of Vetrimil may include dizziness, fatigue, and potential kidney issues. Regular monitoring of kidney function and blood pressure is recommended.

- Short-term side effects can include hypotension (low blood pressure), which may cause dizziness or fainting, especially when standing up quickly.

- Erispan can cause side effects such as nausea, insomnia, sexual dysfunction, and increased sweating. Long-term use may lead to withdrawal symptoms if discontinued abruptly.

2. Managing MVP Symptoms
For someone with simple mitral valve prolapse who experiences symptoms like chest discomfort, palpitations, and anxiety, lifestyle modifications are essential. These include:
- Sleep: Ensuring adequate rest can help manage symptoms.

- Diet: A heart-healthy diet low in sodium and saturated fats is beneficial.

- Emotional Well-being: Stress management techniques, such as mindfulness or therapy, can help alleviate anxiety that may exacerbate symptoms.

In terms of pregnancy and lifespan, MVP typically does not pose significant risks. Most women with MVP can have healthy pregnancies, but they should be monitored by a healthcare provider.

3. Transition to Mitral Regurgitation
If MVP progresses to mitral regurgitation (MR), where blood leaks backward into the left atrium, the implications can vary:
- Daily Life: Symptoms may worsen, leading to increased fatigue, shortness of breath, and palpitations.

- Lifespan: Untreated severe MR can lead to heart failure, which may impact lifespan. Regular follow-up with a cardiologist is crucial.

- Pregnancy: Women with significant MR may face higher risks during pregnancy and should be closely monitored.

4. Mitral Valve Thickening
If MVP leads to mitral valve thickening, the effects can include:
- Daily Life: Symptoms may remain stable, but monitoring is essential as thickening can lead to stenosis (narrowing of the valve).

- Lifespan: Generally, mild thickening does not significantly impact lifespan, but severe cases may require intervention.

- Pregnancy: Similar to MR, women with significant thickening should be monitored closely.

5. Complications and Surgical Considerations
If complications arise, such as severe MR or infective endocarditis, surgical intervention may be necessary. The costs of mitral valve surgery can vary widely based on location, hospital, and whether the valve is repaired or replaced. In the U.S., costs can range from $30,000 to over $100,000, depending on the complexity of the case and insurance coverage.

Surgical Risks:
- Risks include bleeding, infection, and complications related to anesthesia. Long-term risks can include valve dysfunction or the need for reoperation.

Types of Valves:
- Mechanical valves are durable but require lifelong anticoagulation therapy.

- Biological valves (tissue valves) may not last as long but do not require long-term anticoagulation. Availability may depend on donor tissue, and there can be waiting periods for suitable matches.

In conclusion, while MVP can lead to various symptoms and complications, with proper management and regular follow-up, many individuals can lead healthy lives. It is essential for your friend to maintain open communication with their healthcare provider to monitor their condition and adjust treatment as necessary. Thank you for your thoughtful questions, and I hope this information helps clarify your concerns regarding mitral valve prolapse.

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