Mitral Valve Prolapse: Symptoms and Heart Health Concerns

Mitral valve prolapse

Hello Doctor, I am a young woman with mitral valve prolapse and mild regurgitation.
There is a slight backflow of blood, but overall, my heart function remains within normal limits.
Recently, I have been experiencing sudden dizziness and prolonged chest pain.
I have a history of chest pain, palpitations, and shortness of breath, but the frequency of these episodes has increased lately.
The timing of the episodes is unpredictable, and sometimes I also experience cold sweats.
Every morning when I wake up, I definitely have an episode.
During my health check last year, my blood pressure was slightly elevated.
I would like to ask the doctor if these symptoms are related to my heart.
Sometimes I feel discomfort in my stomach, but shortly after, I also experience chest pain.
What could be causing these issues in my body? Thank you, Doctor, for taking the time to answer my questions.
I greatly appreciate it.

You, 20~29 year old female. Ask Date: 2007/02/08

Dr. He Dongjin reply Cardiology

DEAR GIGI, the symptoms mentioned above are mostly caused by autonomic nervous system dysfunction and are also related to mitral valve prolapse.
It is advisable to use some medications for control and to visit a cardiology clinic for a detailed examination.
Changhua Hospital is concerned about you.

Mitral valve prolapse, also known as mitral valve insufficiency, is often associated with a tall and slender physique, which is a model figure that many girls dream of.
However, in the eyes of physicians, this slender body type and sensitive personality are typical characteristics of patients with mitral valve prolapse.
About 5% of the population is affected by this condition, with a notably higher incidence in females, who are twice as likely to be affected as males.
The most prominent features of these patients are being thin and tall.

If there are mucinous changes in the connective tissue of the valve during embryonic development, leading to elongated and lax valves, prolapse may occur later.
When the heart contracts, the elongated valve cannot close properly, causing blood to flow back from the left ventricle into the left atrium.
In addition to the characteristic click of the prolapsed valve, heart murmurs may also be heard.
Patients with this abnormal constitution often experience various symptoms from head to toe, such as dizziness, insomnia, palpitations, chest pain, panic, fatigue, chest tightness, numbness throughout the body, shortness of breath, and gastrointestinal discomfort.
This may be related to autonomic nervous system dysfunction, which involves either excessive or insufficient responses from the sympathetic or parasympathetic nervous systems.
Clinically, patients may present with various types of arrhythmias, including sinus tachycardia (the most common), bradycardia, ventricular tachycardia, atrial flutter, atrial fibrillation, or even cardiac arrest.
The chest pain associated with mitral valve prolapse can sometimes be difficult to distinguish from angina or myocardial infarction.
The underlying cause may be the excessive back-and-forth motion of the elongated valve, which can overly strain the heart muscle, leading to localized hypoxia, arrhythmias, and autonomic nervous system dysfunction.
Mitral valve prolapse is also commonly found in patients with congenital heart diseases (such as atrial septal defects), hypertrophic cardiomyopathy, and some congenital connective tissue disorders (such as Marfan syndrome).
Patients with prolapse symptoms may seem to have ailments throughout their bodies, but over 90% of cases are benign.
Aside from being somewhat anxious, they do not pose significant health risks.
Regular exercise, adequate rest, and occasional use of small doses of beta-blockers or sedatives are usually sufficient.
Only a small percentage of patients (about 1%) may develop complications such as heart failure, endocarditis, arrhythmias, stroke, or sudden death.
Therefore, patients with mitral valve prolapse, especially those with significant heart murmurs, should have follow-up examinations at least once a year.

Reply Date: 2007/02/08

More Info

Mitral Valve Prolapse (MVP) is a condition where the two flaps of the mitral valve do not close properly, which can lead to a variety of symptoms and potential complications. Your description of experiencing symptoms such as dizziness, chest pain, palpitations, and shortness of breath, especially with the recent increase in frequency, raises important considerations regarding your heart health.

Understanding Mitral Valve Prolapse
MVP is often benign, especially when it is mild and does not cause significant mitral regurgitation (MR). However, in some cases, it can lead to complications such as arrhythmias, which are irregular heartbeats, and more severe forms of MR. The symptoms you are experiencing could be related to MVP, particularly if there is associated MR. The mild regurgitation you mentioned indicates that some blood is flowing backward into the left atrium when the left ventricle contracts, which can lead to increased pressure and volume in the left atrium over time.

Symptoms and Their Implications
1. Dizziness and Palpitations: These symptoms can occur due to arrhythmias, which are more common in individuals with MVP. The heart may beat too fast or irregularly, leading to feelings of dizziness or lightheadedness.
2. Chest Pain: This can be multifactorial. In some cases, it may be related to the heart itself, especially if there is ischemia (reduced blood flow) due to the heart's workload or arrhythmias. However, it can also be due to musculoskeletal issues or gastrointestinal problems, such as acid reflux, which can mimic cardiac symptoms.

3. Shortness of Breath: This symptom can arise from several causes, including heart function issues, particularly if the left ventricle is not pumping effectively due to volume overload from MR. It can also be related to anxiety, which is common in patients with MVP.

4. Cold Sweats: This can be a sign of anxiety or panic attacks, which can occur in conjunction with MVP. However, it can also indicate more serious cardiac issues, especially if accompanied by other concerning symptoms.

5. Gastrointestinal Discomfort: The connection between gastrointestinal symptoms and cardiac issues is well-documented. Sometimes, discomfort in the stomach can be referred pain from the heart, or it could be a separate issue such as gastritis or gastroesophageal reflux disease (GERD).

Recommendations
Given your symptoms and history of MVP with mild MR, it is crucial to consult with your cardiologist. Here are some steps you might consider:
- Comprehensive Evaluation: A thorough evaluation, including an echocardiogram, can help assess the severity of your MVP and MR. It can also check for any changes in heart function or structure.

- Holter Monitor: If palpitations are frequent, a Holter monitor can record your heart's rhythm over 24-48 hours to identify any arrhythmias.

- Blood Pressure Monitoring: Since you mentioned slightly elevated blood pressure, regular monitoring is essential. Managing blood pressure is crucial for overall heart health.

- Lifestyle Modifications: Consider lifestyle changes such as reducing caffeine and alcohol intake, managing stress, and engaging in regular physical activity, which can help mitigate some symptoms.

- Symptom Diary: Keeping a diary of your symptoms, including when they occur and their duration, can provide valuable information for your healthcare provider.

Conclusion
Your symptoms warrant further investigation to rule out any serious complications associated with MVP and to ensure that your heart health is being appropriately managed. While MVP can be a benign condition, the increase in your symptoms suggests that a more detailed assessment is necessary. Please ensure to discuss your concerns and symptoms with your healthcare provider, who can guide you through the appropriate diagnostic and therapeutic options.

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Hello, it seems that having valve prolapse along with autonomic nervous system dysfunction is normal. You can manage symptoms by taking medication when they occur. Changhua Hospital cares about you.

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