Mitral Valve Prolapse with Regurgitation: Key Concerns and Care

Mitral valve prolapse with regurgitation?

Hello Dr.
Lin, last week I had a heart examination at Lixin Hospital in Zhongli, and the doctor diagnosed me with "mitral valve prolapse with regurgitation." It seems that mitral valve prolapse is quite common, but the doctor mentioned that having "regurgitation" at such a young age requires special attention.
This has made me very worried.
Besides regular annual check-ups, will this condition affect my daily life and health?
(Q1) The doctor suggested that I go to National Taiwan University for a more detailed examination, but I heard that health insurance only covers echocardiograms once a year.
Can I still go to NTU for an examination?
(Q2) Recently, I have been experiencing rapid, loud, and forceful heartbeats that I can feel, which is quite uncomfortable, and my heartbeat is irregular.
Sometimes, my fingertips tremble.
The doctor prescribed "Inderal" and "Deanxit tab." Are these medications effective? Should I take them only when I'm uncomfortable, or should I take them at fixed times?
(Q3) Lastly, will sleeping on my left side have any impact if I have heart issues?
(Q4)

Winnie, 20~29 year old female. Ask Date: 2005/01/14

Dr. Lin Liangyu reply Cardiology

Mitral valve prolapse refers to the condition where the mitral valve of the heart is pushed towards the left atrium during contraction.
The characteristic of this condition is the presence of autonomic nervous system dysregulation, which may include symptoms such as chest tightness, chest pain, palpitations, and arrhythmias.
Although the symptoms can be severe, they rarely pose a threat to life.
Generally, the response to Inderal (propranolol) is quite good, as it can suppress the excessive stimulation of the autonomic nervous system.
If episodes have been frequent recently, it is advisable to take the medication regularly, and once symptoms improve, switch to taking it only when discomfort arises.
In daily life, it is important to avoid stimulants and not to stay up late.
Only a small number of individuals may develop significant mitral regurgitation leading to heart failure.
If the regurgitation is mild, there is no need for excessive concern; checking every two to three years is sufficient.
There is no need to visit multiple hospitals, as it may only add to your distress.
Regarding sleep, studies have found that lying on the left side may stimulate the autonomic nervous system more.
Wishing you a speedy recovery.

Reply Date: 2005/01/14

More Info

Mitral valve prolapse (MVP) with regurgitation is a condition where the mitral valve does not close properly, allowing blood to flow backward into the left atrium of the heart. This condition can be relatively common and often benign, especially in younger individuals. However, the presence of regurgitation can lead to various concerns regarding heart function and overall health.

Understanding MVP with Regurgitation
1. Impact on Health and Lifestyle: While many people with MVP experience no symptoms, the presence of regurgitation can lead to complications such as heart palpitations, fatigue, and in some cases, heart failure. It is essential to monitor the condition regularly, as significant regurgitation may require medical intervention. In your case, experiencing rapid, forceful heartbeats and irregular rhythms can be concerning and should be evaluated further. Regular check-ups and echocardiograms are crucial to assess the severity of the regurgitation and the function of the heart.

2. Follow-Up Care: Regarding your question about follow-up care and the frequency of echocardiograms, it is true that health insurance typically covers one echocardiogram per year. However, if your physician at the hospital recommends further evaluation at a specialized center like National Taiwan University Hospital, it is advisable to follow that recommendation. The additional tests can provide more detailed insights into your heart's condition, which is particularly important given your symptoms.

3. Medication Management: The medications prescribed, Inderal (a beta-blocker) and Deanxit (an anxiolytic), can help manage symptoms associated with MVP and anxiety. Inderal can help reduce heart rate and alleviate palpitations, while Deanxit may assist with anxiety-related symptoms. It is essential to take these medications as prescribed. If you are experiencing discomfort, it is generally advisable to take them consistently rather than only when symptoms arise. However, you should consult your physician regarding the best approach to your medication regimen.

4. Sleep Position: As for your concern about sleeping on your left side, it is generally safe for individuals with MVP to sleep in any position they find comfortable. However, if you notice that sleeping on your left side exacerbates your symptoms, you may want to try sleeping on your back or right side. It is essential to listen to your body and adjust your sleeping position accordingly.

Additional Considerations
- Lifestyle Modifications: Maintaining a healthy lifestyle can significantly impact your heart health. This includes regular exercise, a balanced diet, and avoiding stimulants such as caffeine and nicotine, which can exacerbate palpitations.

- Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur and their severity. This information can be helpful for your healthcare provider in managing your condition.

- Emotional Well-being: Anxiety can often accompany heart conditions, leading to a cycle of increased heart rate and discomfort. Engaging in relaxation techniques, such as deep breathing exercises or mindfulness, may help alleviate some of the anxiety associated with your symptoms.

In conclusion, while MVP with regurgitation can be concerning, many individuals live healthy lives with this condition. Regular follow-ups, appropriate medication management, and lifestyle adjustments can help you manage your symptoms effectively. Always communicate openly with your healthcare provider about any new or worsening symptoms, and do not hesitate to seek further evaluation if needed.

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