Mitral and Tricuspid Valve Prolapse: Symptoms and Management

Valvular prolapse issues

Last year, I experienced sudden strong heartbeats and a warm sensation in my left chest when I was fatigued.
After undergoing an echocardiogram, a 24-hour Holter monitor, and some blood tests, I was diagnosed with mitral valve prolapse and tricuspid valve prolapse, which did not require medication.
I learned that when my heart feels uncomfortable due to fatigue, I should just rest.
However, last Tuesday, shortly after waking up, I bent down to pick something up and suddenly felt chest pain.
I couldn't stand up straight and had difficulty taking deep breaths, with pain and numbness extending to my left arm and back.
It lasted for about 30 minutes and then subsided, so I didn't pay much attention to it.
On Sunday, I also woke up with persistent chest pain that radiated to my left upper arm.
Although it wasn't as painful as before, it lasted for over two hours, which made me a bit worried.
I went to the emergency room for an ECG and was prescribed Inderal 10 mg.
I forgot to take the medication when I got home and went to sleep.
When I woke up, I still felt pain, but after taking the medication, I felt fine upon waking up.
I would like to ask if valve prolapse can worsen? Given my medical history, how should I handle chest pain? In the past, I would only experience palpitations after consuming stimulating beverages, but now I often have unexplained palpitations without significant emotional fluctuations, which is quite concerning.

Xiao Mi, 20~29 year old female. Ask Date: 2012/04/10

Dr. He Dongjin reply Cardiology

Hello, actually, the issue of mitral valve prolapse is not significant, and the chances of deterioration are low.
The symptoms often vary greatly and are mostly caused by autonomic nervous system dysregulation.
Patients with this condition tend to be more sensitive to changes in their internal and external environments, including poor indoor ventilation, changes in atmospheric pressure, seasonal transitions, sudden temperature fluctuations, and internal bodily conditions such as menstrual cycles, emotional fluctuations, stress, lack of sleep, and anger.
All of these can lead to autonomic nervous system dysregulation, which in turn can exacerbate the symptoms of mitral valve prolapse.
It is recommended to take medication regularly during periods of unstable symptoms, and to add extra doses as needed.
The dosage of this medication is low, has minimal side effects, and does not harm the stomach, so there is no need to worry about it causing significant harm to the body or kidneys, or leading to dependency or addiction.
Changhua Hospital cares about you.

Reply Date: 2012/04/10

More Info

Mitral and tricuspid valve prolapse (MVP and TVP) are conditions where the heart's valves do not close properly, leading to potential complications such as regurgitation, arrhythmias, and in some cases, chest pain or discomfort. Understanding these conditions, their symptoms, and management strategies is crucial for patients experiencing related symptoms.

Symptoms of Mitral and Tricuspid Valve Prolapse
Patients with MVP and TVP may experience a variety of symptoms, although many individuals remain asymptomatic. Common symptoms include:
1. Palpitations: Many patients report feeling their heart racing or fluttering, especially during periods of stress or fatigue.

2. Chest Pain: This can vary in intensity and may be sharp or dull. It can sometimes mimic angina, leading to confusion about its origin.

3. Fatigue: Patients may feel unusually tired, particularly after exertion.

4. Shortness of Breath: This can occur during physical activity or even at rest in more severe cases.

5. Dizziness or Lightheadedness: Some individuals may experience these symptoms, especially if they have associated arrhythmias.

Management of Mitral and Tricuspid Valve Prolapse
Management strategies for MVP and TVP depend on the severity of the condition and the presence of symptoms. Here are some general approaches:
1. Regular Monitoring: For asymptomatic patients or those with mild symptoms, regular follow-up with a cardiologist is essential. This may include echocardiograms to monitor valve function over time.

2. Lifestyle Modifications: Patients are often advised to maintain a healthy lifestyle, including regular exercise, a balanced diet, and avoiding stimulants such as caffeine and nicotine, which can exacerbate palpitations.

3. Medications: In cases where symptoms are more pronounced, medications such as beta-blockers (like Inderal) may be prescribed to help manage palpitations and anxiety. It is important to take these medications as directed.

4. Education and Awareness: Patients should be educated about their condition, including recognizing symptoms that warrant immediate medical attention, such as severe chest pain, shortness of breath, or syncope (fainting).

5. Surgical Intervention: In rare cases where there is significant regurgitation or other complications, surgical repair or replacement of the affected valve may be necessary.

Addressing Your Concerns
Given your recent experiences with chest pain and palpitations, it is understandable to feel anxious. The episodes you described, particularly the chest pain radiating to your left arm and back, warrant careful evaluation. While MVP and TVP can lead to discomfort, they do not typically worsen dramatically over time unless associated with significant regurgitation or other heart conditions.

When you experience chest pain, especially if it is accompanied by symptoms like shortness of breath or pain radiating to the arm, it is crucial to seek immediate medical attention. While your symptoms may be related to your valve conditions, they could also indicate other cardiac issues that need to be ruled out.

Conclusion
In summary, mitral and tricuspid valve prolapse can lead to various symptoms, including palpitations and chest pain. Regular monitoring, lifestyle changes, and appropriate medication can help manage these conditions effectively. However, it is essential to remain vigilant about new or worsening symptoms and to communicate openly with your healthcare provider about any concerns. If you experience chest pain again, especially if it is severe or prolonged, do not hesitate to seek emergency care. Your health and peace of mind are paramount.

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