Mitral Valve Prolapse Concerns

  My question is in two parts.  I am a 31 year old female who has been diagnosed with mitral valve prolapse in 1997.  Medical history:  I have had several years of unexplained chest pain with other symptoms including lightheadedness, dizziness, shortness of breath (during activities and while doing nothing), and fatigue. I also experience pain in my arms, legs, and neck, and also on several occasions, numbness to my face with my left eye and the left side of my mouth drawing down. I have been diagnosed with mild prolapse with trace mitral regurgetation.  My diagnosis paper says I have a midsystolic click and a systolic murmur.  I have been prescribed Inderal for the chest pains to take as needed.  Question:  What can be done about this, if anything, and how do I go about getting it done?
  The second part relates to the first in regards to my blood pressure.  I have had a problem with it going up, but by the time I get to the doctor, it is back down to or close to normal range.  No medication has been prescribed.  My eye doctor had done a field exam on my eyes and questioned me about high blood pressure.  He said it showed up as if it was someone who had had a stroke settle in their eyes, but mine was not quite to that point.  He suggested I tell my doctor, which I did, but nothing was done about this.  Question:  Does this have anything to do with my MVP or could this possibly be a mini-stroke because of my numbness in my face and the drawing up?(It lasted for about 3 days and then went back to normal.  Still does it occassionally.)
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Dear Christina:
The many symptoms that you describe are concerning.  You need a detailed echocardiogram (cardiac ultrasound) to determine whether there is a problem with your valve or other heart structures.  If there is any ambiguity regarding the findings of the regular echocardiogram, you should have a transesophageal echocardiogram (TEE) performed.  A TEE is somewhat of an invasive procedure that involves passing a narrow tube down the esophagus (the food pipe) to look at the heart from behind.  This test would also determine if you have any blood clots or other abnormalities in the heart that might be a cause of stroke or mini-stoke.  
You should probably also have the possibility of fast or irregular heart beats investigated with a Holter monitor, a device that is worn by a patient to record the heart beat.
The episodic high blood pressure deserves further evaluation.  If your blood pressure really is significantly elevated at times, there are a number of blood tests that can be checked to see if you have one of the rare conditions that can lead to episodic high blood pressure and also some of the symptoms that you described.
You should have a detailed examination by a cardiologist to determine the status of your valve, your heart, and your blood pressure.  You should also see a neurologist to determine why your numbness is occurring;  you ought to look into this immediately.  Good luck.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist who specializes in valve diseases at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.