Mitral Valve Prolapse: Symptoms, Diagnosis, and Concerns

Mitral valve prolapse

Dear Doctor: I have been feeling more anxious over the past three months, with a rapid heartbeat, reaching up to around 110 beats per minute at its highest.
I experienced a sensation of shortness of breath once, feeling as if I was about to die.
The doctor mentioned that my rapid heartbeat is caused by autonomic nervous system dysregulation, and it has improved somewhat this month, averaging around 85 beats per minute.
I have had three normal resting electrocardiograms.
Today, I experienced more noticeable chest pain, but the pain is brief, lasting no more than one second.
During my examination, my heart rate was 102 beats per minute, and the doctor noted that I have mild mitral valve prolapse and elongated heart valves.
I would like to ask:
1.
How did he determine that I have mild mitral valve prolapse and elongated heart valves using only a stethoscope for the examination? I have never been informed of these conditions before, and hearing this today was quite shocking.

2.
The chest pain has only occurred in the past three months; I have never experienced it before.
I feel it is more like a muscle or nerve cramp, as the pain is instantaneous and completely disappears after one second, occurring approximately once every half hour.
(Over the past three months, I have also felt this cramping sensation when swallowing.) Do you think my chest cramps are related to the mild mitral valve prolapse and elongated heart valves mentioned by the doctor, or do they seem more like muscle or nerve cramps in the chest? (I have experienced this cramping sensation on both the left and right sides of my chest, with the middle of my chest being the most frequent site of discomfort.) Thank you very much for your patience in reading this.

Jian, 20~29 year old female. Ask Date: 2015/12/11

Dr. He Dongjin reply Cardiology

Hello, the symptoms you mentioned, such as mild mitral valve prolapse or chest muscle nerve pain, could be related to your recent anxiety.
However, the likelihood of mitral valve prolapse is higher.
If you are concerned, I recommend getting an echocardiogram at an outpatient clinic for a definitive diagnosis.
Changhua Hospital cares about you.

Reply Date: 2015/12/11

More Info

Mitral Valve Prolapse (MVP) is a condition where the mitral valve, which separates the left atrium from the left ventricle of the heart, does not close properly. This can lead to a range of symptoms and concerns, particularly when associated with anxiety and palpitations, as you've described. Let's break down your concerns regarding MVP, its symptoms, diagnosis, and the potential relationship to your chest pain.

Symptoms of Mitral Valve Prolapse
MVP can present with a variety of symptoms, although many individuals may remain asymptomatic. Common symptoms include:
1. Palpitations: This is the sensation of feeling your heart beating rapidly or irregularly. Given your reported heart rate of up to 110 beats per minute, this could be related to MVP, especially if you are experiencing anxiety.

2. Chest Pain: While chest pain can be associated with MVP, it is often atypical and can be sharp or fleeting, as you described. The pain lasting only a second and occurring intermittently may suggest a non-cardiac origin, such as musculoskeletal pain or anxiety-related symptoms.

3. Shortness of Breath: This can occur, particularly during exertion or anxiety episodes.

4. Fatigue: Some individuals report feeling unusually tired.

Diagnosis of Mitral Valve Prolapse
Diagnosis of MVP is typically made through a combination of patient history, physical examination, and echocardiography. Here’s how your doctor may have arrived at the diagnosis:
1. Physical Examination: A healthcare provider can often detect MVP through auscultation (listening to the heart with a stethoscope). They may hear a characteristic "click" sound followed by a murmur if there is regurgitation (backflow of blood).

2. Echocardiogram: This imaging test uses sound waves to create pictures of the heart. It can confirm the presence of MVP and assess the severity of any associated regurgitation.

3. Electrocardiogram (ECG): While your ECG results were normal, this test can help rule out other cardiac issues.

Concerns Regarding Your Symptoms
1. Anxiety and Heart Rate: Your elevated heart rate and feelings of anxiety can be interconnected. Anxiety can lead to increased sympathetic nervous system activity, which can cause palpitations and a rapid heart rate. It’s important to address both the physical and psychological aspects of your symptoms.

2. Chest Pain: The transient nature of your chest pain, especially if it feels like muscle or nerve pain, may not be directly related to MVP. Conditions such as costochondritis (inflammation of the cartilage connecting the ribs to the sternum) or muscle strain can cause similar symptoms. However, it’s crucial to monitor these symptoms, especially if they change in character or frequency.

3. Mitral Valve Prolapse and Symptoms: While MVP can cause symptoms, it is often benign, especially if there is no significant regurgitation. The symptoms you are experiencing may be multifactorial, involving anxiety, MVP, and possibly musculoskeletal issues.

Recommendations
1. Follow-Up with Your Doctor: It’s essential to discuss your symptoms in detail with your healthcare provider. They may recommend further evaluation, such as an echocardiogram if not already done, to assess the mitral valve's function and any potential regurgitation.

2. Manage Anxiety: Consider strategies to manage anxiety, such as cognitive-behavioral therapy (CBT), relaxation techniques, or medication if necessary. Reducing anxiety may help alleviate some of your palpitations and associated symptoms.

3. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their duration, and any associated activities or stressors. This information can be valuable for your healthcare provider.

4. Lifestyle Modifications: Regular exercise, a balanced diet, and adequate hydration can support overall cardiovascular health. Avoiding stimulants like caffeine may also help reduce palpitations.

In conclusion, while MVP can be associated with various symptoms, it is essential to consider the broader context of your health, including anxiety and potential musculoskeletal issues. A thorough evaluation by your healthcare provider will help clarify the situation and guide appropriate management.

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