Another Echo?

  I'm a 42 year old female with MVP, confirmed with an echo two years ago.  I've always been fit and work out 4 days per week.  My concern is I get winded just going upstairs (short bursts have always been troublesome but it seems worse lately).  Also, occasionally
  I have slight chest pressure that lasts several hours in a day.  Should I request another echo to check for regurgitation?  How serious could this be?
  Thank you.  

[Cleveland Clinic, MD]

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Dear Claudia,

Thank you for your question.  Mitral valve prolapse (MVP) is a condition of the mitral valve where the leaflets of the valve cross back into the atrium (upper chamber) of the heart during the pumping phase of the heartbeat.  It is a congenital (something one is born with) condition that may progress with age and not be detected until later in life.  Certain diet drugs (i.e. redux) may be associated with MVP.  MVP  is more common in women and has been associated (but not demonstrated to cause) with a number of symptoms such as palpitations, panic attacks and other complaints.   There may be some back-flow of blood into the atrium due to the prolapse and this is called mitral regurgitation.  Mitral valve prolapse may progress and it would not be unreasonable to have another echo if it has been two years since your last one.
MVP is generally a benign process and does not usually require any special treatment or cause for concern.  If there is mitral regurgitation associated with MVP antibiotics are recommended before dental procedures and certain other medical procedures to reduce the risk of an infection starting on the valve (endocarditis).  Severe regurgitation due to MVP may require surgery to repair the valve.
Supraventricular tachycardias are fast heart beats originating from the upper chambers of the heart.  They may be associated with MVP and are often treated with beta-blockers.  Potential side-effects of beta-blockers are fatigue, depression and impotence in men.  If you notice any of these symptoms you should notify your doctor.  Here are some additional websites with information on MVP.

http://www.stayhealthy.com/hrdfiles/hrd00277.html
http://www.beWELL.com/healthy/woman/1997/mvp/
http://www.geocities.com/HotSprings/6911/
http://www.rxmed.com/illnesses/mitral_valve_prolapse.html
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.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.