Mild Heart Conditions: Managing Symptoms Without Medication

The symptoms of heart disease are becoming increasingly severe?

Hello, Doctor.
I was recently diagnosed with mitral valve prolapse with mild mitral regurgitation, mild aortic regurgitation, mild tricuspid regurgitation, and probable pulmonary hypertension.
The doctor prescribed Inderal and Xanax, advising me to take the medication sparingly.
Initially, I took the medications for four days, three times a day, but felt extremely drowsy.
After researching the side effects, I became hesitant to continue taking them.
Before taking the medication, I occasionally experienced mild pain, which did improve while on the medication.
However, after deciding to stop (first reducing the frequency, then stopping Inderal completely over about two days), I initially felt very heavy and fatigued in my chest upon waking up, and subsequently, the heart pain gradually returned, increasing in severity and accompanied by new sensations of pain.
Although I have stopped the medication, the drowsiness has not improved.
Additionally, when lying flat at night, I experience rib pain; during the day, it often feels like there is phlegm in my lungs, my swallowing function has worsened, and I produce a loud swallowing sound.
Therefore, I would like to ask: 1.
Is it necessary to return for a follow-up appointment? Because: (1) the doctor believes my condition is mild and that I may not need medication, (2) if the doctor prescribes medication, are there alternatives available? 2.
If I choose not to take medication, how can I manage the pain? Thank you, Doctor.

coeur, 30~39 year old female. Ask Date: 2007/10/04

Dr. Zhuang Junbin reply Cardiology

Hello Coeur,
1.
If you experience any reactions due to side effects from other medications after taking your prescribed drugs, you can return for a follow-up consultation with your physician.
Based on the symptoms reported by the patient, the current treatment with Inderal (10 mg) and Xanax is appropriate, and there is no need to substitute with other medications.
However, it is recommended to primarily use Inderal (10 mg) when feeling unwell, taking it twice daily, with each dose being half a tablet (which can be increased to one full tablet of Inderal (10 mg)).
If taking only Inderal (10 mg) does not effectively alleviate chest pain, you may increase Xanax to half a tablet per dose (twice a day).
If you experience drowsiness as a side effect of Xanax, you can take it only at night and avoid taking it during the day.
2.
If you choose not to take medication, it is advisable to avoid beverages such as coffee, tea, and alcohol, and to maintain a regular sleep schedule to ensure adequate rest, which can help prevent frequent episodes of chest pain.
Wishing you good health!

Reply Date: 2007/10/04

More Info

It's understandable to feel anxious and concerned about your heart health, especially after receiving a diagnosis of mild mitral valve prolapse with mild regurgitation, aortic regurgitation, tricuspid regurgitation, and probable pulmonary hypertension. These conditions can indeed cause symptoms like chest discomfort, palpitations, and fatigue, which can be distressing. Let's address your questions and concerns in detail.

1. Is a follow-up appointment necessary?
Given your symptoms and the changes you've experienced after stopping medication, it would be prudent to schedule a follow-up appointment with your healthcare provider. Even if your doctor initially deemed your condition mild, any new or worsening symptoms warrant further evaluation. It's essential to communicate the changes you've noticed, such as increased chest pain, feelings of heaviness, and any respiratory issues. Your doctor can reassess your condition and determine if further tests or a different treatment approach is necessary.

2. Are there alternative medications?
If you're uncomfortable with the side effects of Inderal (propranolol) and Xanax (alprazolam), it's important to discuss this with your doctor. There are various alternatives depending on your specific symptoms and overall health. For instance, if anxiety is a significant factor, cognitive-behavioral therapy (CBT) or other non-pharmacological approaches may be beneficial. Additionally, other medications for anxiety or heart rate control may have different side effect profiles. Your healthcare provider can help you find a suitable alternative that minimizes side effects while effectively managing your symptoms.

3. How to manage pain without medication?
Managing symptoms without medication can be challenging, but there are several strategies you can employ:
- Lifestyle Modifications: Regular physical activity, such as walking or gentle yoga, can improve cardiovascular health and reduce anxiety. However, it's important to listen to your body and avoid overexertion.

- Stress Management: Techniques such as mindfulness, meditation, and deep breathing exercises can help reduce anxiety and improve your overall sense of well-being. Engaging in hobbies or activities that you enjoy can also provide a positive distraction.

- Dietary Changes: A heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins can support cardiovascular health. Staying hydrated and reducing caffeine and alcohol intake may also help alleviate some symptoms.

- Sleep Hygiene: Establishing a regular sleep schedule and creating a restful sleep environment can improve sleep quality. If you experience discomfort while lying down, consider adjusting your sleeping position or using extra pillows for support.

- Physical Therapy: If you experience persistent pain, consulting a physical therapist may provide relief through targeted exercises and techniques.

4. Monitoring Symptoms
It's crucial to keep a journal of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable during your follow-up appointment, helping your doctor understand your condition better and tailor a treatment plan that suits your needs.

Conclusion
While mild heart conditions can often be managed effectively with lifestyle changes and careful monitoring, it's essential to maintain open communication with your healthcare provider. If you notice any significant changes in your symptoms or if your anxiety about your heart health increases, don't hesitate to seek medical advice. Remember, you are not alone in this journey, and there are resources and support available to help you manage your health effectively.

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