Constant lightheadedness

  I am a 34 year old female experiancing constant lightheadedness & fatigue for the past 2 1/2 years.  Other symptoms include difficulty concentrating, blurry vision (slight), unable to tolerate sweets.  My lightheadedness does not accompany spinning but I can no longer tolerate amusement park rides that involve twirling.  After seeing several different Dr.'s in my HMO during the first year of symptoms I was told I had everything from Chronic Fatigue Syndrome to TMJ.  I've been fortunate to have been seen for the past year by the same Dr. however he is perplexed by my symptoms.  I have had two MRI's with negative results. The ENT Dr. took a quick look and diagnosed TMJ.  I don't feel this is my problem.  I have had several blood tests and a glucose tolerance test which do not indicate hyper or hypoglycemia or anemia. My blood pressure is normal. I have had several bouts of sinus infections during this period which are treated with antibiotics.  I am using Flonase daily to help keep my sinus' open.  Could these recurrent infections be causing my symptoms? Although I don't see the link between my sinus' and my inability to tolerate sugar.  I had been a very healthy, allergy free person until coincidentaly the birth of my second child 2 1/2 years ago.  I forgot to mention I just had an echocardiogram done and am awaiting the results.  The tech saw nothing highly unusual but did mention I had slight mitral valve prolapse with sight leakage(?).  Any insight or other avenues of research you could suggest would be most welcome.
  Monica

[Cleveland Clinic, MD]

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Dear Monica,

Mitral valve prolapse does not usually cause dizziness.  I would be more suspicious of  inner ear problems. 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.  
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.