MVP and exercise

[Bary]

     I have just been diagnosed with minor mitral valve prolapse which has been causing
  PACs.  I have noticed an occasional skipped beat and then a hard beat for a few years.
  Recently it has changed to 1/2hour to 3 hour bouts of continuously irregular heartbeats.
  This has caused me to seek out a cardiologist and a diagnosis.
  I was given an Echocardiogram which found that I had a prolapsed mitral valve--
  which the doctor said was mildly prolapsed.  He said all my other valves looked good.
  He also said that at this time he thinks I am in no danger and that treatment is not
  absolutely necessary but if I feel more comfortable taking the 25mg of Lopressor that has all
  but stopped my PACs that I should continue.  
      Before these runs of continuous irregularity scared me I was playing full court basketball
  3 days a week.  I stopped because of the PACs.  They would start as soon as I sat down to rest.
  It seemed that If I sat down to rest before I got my "Second Wind" that it would happen more.
  If I could play through my second wind I would be fine.  I did not have tachycardia, just really
  screwed up irregular heartbeats(no shortness of breath or pain)--though occasionally it would scare
  me real good.
      I realize that I am rambling but let me sum up my medical status and ask you the real question
  that I meant to ask.
     -I am 32 years old and in good physical condition.
     -I was told I have Minor MVP  with no or extremely minor regurgitation.
     -I have a blood pressure of around 120/70
     -While taking Lopressor 25mg once a day at bedtime my pulse is typically 40-70.
     -before I began the lopressor my pulse was typically about 60.
     -my cardiologist said that he wants to see me again in 1 year.
     -my only bad habit is smoking cigarrettes. about 12 per day.
     -I realize that smoking is bad and can worsen these symptoms
      but have a hard time believing that I can actually quit.
  I have 3 questions:
  1) I have noticed that my pulse is markedly higher when I stand versus sit or lay down.
     Example:  As I write this question while sitting my pulse is 68.  Now standing my pulse is
     88.  I sit back down and it is back to 68.  Is this normal??
  2) I would like to return to playing basketball. (my doctor says that my condition is not really
     dangerous but he cannot recommend that I do or don't play) He wants no liability and I can't say
     that I blame him.  He basically said play if I want.  I am concerned that I will have PACs again
     when I play.  I intend to take the 25mg of Lopressor once a day that I have been taking.  I feel ok
     with that.  My question is If I play and am winded(tired and out of breath from playing ball) and I
     begin to experience PACs what should I do?  I have played with the PACs before and tried to ignore them
     and they might go away.  Then again lately before I saw the cardiologist and stopped playing I became
     fearfull and stopped playing at the first sign of them.  Would you recommend that I stop if I experience
     these palpitations or is that succumbing to anxiety and worsening them?
     Is there any best thing to do to deal with this situation?

[CCF CARDIO MD APS]

_
Dear Barry,
1.STOP SMOKING, IF YOU ARE SERIOUS ABOUT IT AND ARE SERIOUSLY INTERESTED IN YOUR OWN HEALTH YOU WILL BE ABLE TO STOP.  SEEK HELP IN QUITTING IF THAT IS WHAT IT TAKES.
2.The lopressor will likely keep the PACs from occurring even if you exercise. Exercise is the best thing for anyone's heart, and since you are literally killing yourself with the cigarettes, the least you should do is continue your exercise.
Remember, PACs and PVCs are BENIGN which means the prognosis is excellent as these extra or skipped beats have no consequence.
3.NOt only are you succumbing to your anxiety, it is misdirected in the first place.  The skipped beats are nothing to worry about, the continued cigarette smoking is.
4.There is a possibility that you are a little dehydrated and this is why your heart rate increases so much when you stand up, howeverif your blood pressure drops/falls as you stand (as a result of the lopressor) then this would be the natural reaction.
Keep in mind that any heart rate between 60 and 100bpm is considered normal.
5.Your mild prolapse needs to be followed yearly or so because a small percentage of patients will progress to severe prolapse over years (about 10-15%) that eventually requires surgical correction.
I hope that this information has been useful, if you have any further questions please feel free to ask.  Good Luck.
Information provided in the heart forum is intended for general medical informational purposes only, actual diagnosis and treatment can only be made by your physician(s).