Question Title: MVP, Hypothyroidism, and Anxiety

I am 26 years old and was diagnosed last May with hypothyroidism (TSH of 25) and began taking .075 mg synthroid. My principle
complaints were coldness, heart palpitations, and the feeling that my heart was in my throat. Although my TSH is around 2 and
I'm not feeling quite as cold, the other syptoms have not gone away but have actually worsened. I fatigue easily with exercise, have a constantly pounding heart with the palpitions occurring over the course of one or two breaths at least every couple of hours, cold hands and feet, headache, sore neck, etc. My heart rate also seems like it has a difficult time equalizing when I lie down or stand up. I continued to complain to my doctor and was told that I
have anxiety and depression. I've also read, however, that mitral valve prolapse (MVP) is associated with autoimmune thyroid
problems (I'm not sure if mine is autoimmune or not-no tests for antibodies have been done). Since some of the symptoms of mitral valve prolapse are heart palpitations and anxiety among others, I am wondering
if I shouldn't be evaluated for it. I recently wore a holter monitor for a day and was told that I have some type of atrial delay.
Would an MVP show up on an EKG or holter reading or should I pursue further evaluation with an echocardiogram? What is the relationship between anxiety, heart palpitations, hypothyroidism, and MVP? I would
welcome some insight into this as I have had a hard time trying to make my doctor understand that my psychological problems
could actually be the symptom of a physical problem. My frustration is overwhelming.

Dear Tracy, thank you for your question. MVP can be associated with hypothyroidism, but if you do have MVP, your treatment probably wouldn't change. You are being treated appropriately for hypothyroidism since your TSH has normalized on synthroid therapy. Generally, the palpitations that you describe are associated with hyperthyroidism, not hypothyroidism. MVP is caused by redundant, pliable mitral valve leaflets and is associated with a whole range of symptoms from palpitations to fatigue to chest pain. There is some rudimentary evidence that the neural connections to the heart may be overactive in this disorder and that stress and anxiety are often coexisting conditions. There are no specific treatments for MVP, but if you feel that stress and anxiety are a problem for you, then I suggest that you speak to your physician about treatment options. Additionally, avoiding alcohol, tobacco, and caffeine will help to reduce the severity and frequency of your palpitations. Good luck!

I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.

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