Mitral Valve Prolapse

[Richie99]

Dear Sir/Madam,

After suffering from repeated palpitations I was referred to a Cardiologist and had a stress test, 24 hr monitor and Ultrasound scan. These tests showed that I had a 'floppy' Mitral Valve (anterior I think) leaflet with very minor reguritation and was reassured that the palpitations were just the troublesome variety and will play up when I am ill, under stress or have too much caffiene. I did not take well to Atenolol (very sore eyes) so I am now on 10mg of Inderal 3 times a day. All is well with this dosage until I am under pressure at work then it all goes downhill and I have been signed off on a few occasions until they settle down. I have recently been given 80mg of Inderal LA to try which does seem to work but I feel very tired and it effects other areas of my life. Unfortunately, the palpitations do trigger a very high anxiety state with me although I know that they are benign. When I'm at home I just walk round and relax and they pass quite quickly but I really have difficulty if this happens when I'm doing a business presentation for example (Please talk among yourselves while I have a quick anxiety attack!).

Therefore I'm stuck between two extremes. Either I stick to a low dose which works well until I'm stressed and they bring on a sort of panic attack I guess or have a higher dose which blocks them but makes me feel very dosed up. Unfortunately, I seem to be becoming more anxious as time goes on even if I'm not getting palpitations. I'm 41, non-smoker and cycle 2 or 3 times a week for a couple of hours.

I would be grateful for any suggestions that you have that may have as I realise they are not life threatening but they do seem sort of lifestyle threatening.
Best regards

Richard

[Cleveland Clinic, MD]

Dear Richard,
Have you discussed with your doctor the idea of taking a regular low dose and then an increased dose when you need it?  This may be a good compromise between the two extremes. Also has your doctor ever mentioned the use of a serotonin reuptake inhibitor such as Paxil?  These work very well for situations of social stress and anxiety in general.  Hope these thoughts help.  Also you'll find many others at this site who will sympathize with you.

[emma]

Hi - I'm thinking there must be another medication you could try.  Inderal is famous for its side effects.  When I first started taking it, I told my cardiologist about my symptoms and asked whether I might have some bug or whether it could be the Inderal. Of course, he said I must have a touch of something... Every day I'd start falling asleep at work (in a classroom of special ed kids) around 1pm.  Eventually I became something of a zombie - the only way I can describe it.  I'd go to cross the street and couldn't muster the energy or interest to look for traffic.  I looked up Inderal in a book finally and lo - all the side effects I was experiencing.  I went off Inderal finally right before I had heart surgery, and so I can't tell you how much was the surgery and how much going off Inderal, but I felt infinitely better.  I will never(underlined)agree to Inderal again. I have encountered others like me who just couldn't tolerate it. I take Toprol now, also a beta blocker, but without side effects for me.  Good luck!

[Jefrey]

I also was diagnosed with prolapsing leaflet and mild regurgitation.I have had the same symptoms as you are desribing Richard.I am not a physician but I do have a degree in Fluid Mechanics.Actualy what will help and might sound weird
are low dose antibiotics--- they helped me --- (extended release 250 mg of augmentin)taken as a 2 time per week regimen
They helped me a lot.I stay away from Coffee ,Coca Cola and other caffeine beverages,salty foods.It is the only way in which you will treat directly your symptoms by preventing your leaflet from getting bacteria which decrease "localy" the coagulation (they are in everyones blood stream )causing your heart muscle to weaken as it has to pump through a "dirty -leaky " valve-analogical to a car .There is practicaly no valve that is 100% non leaky but they must dstay clean if they are slightly defective.Aspirin might additionaly clean your leaflet.Your prolapse might disapear if you developed it as a result of a previous untreated infection if you consider regular prophylaxis.

[kathie]

Dear Richard
I was diagnosed with MVP about 20 years ago. I also suffer from palpitations. I know exactly how you feel. They can be very disturbing, and nobody understands unless they have had the problem.I still get upset at itmes because they are VERY annoying and I feel like I am doing everything I am supposed to do to prevent them.I have learned however to try to not let it get the best of me.I hope you can take some compfort in the fact that i have had them on and off for a very long time and have had no ill effects except for FRUSTRATION. If you would like to wrtie to me and talk more about this my Email addy is ***@****
Kathie

[connie]

Hi Richard,

I also have MVP and tons of those pesky palpitations.  I was diagnosed about 20 years ago, and took Inderal (various doses) for about 10 years.  I started with 10 mg a couple times a day, and ended up with 80LA and 20mg for break-through episodes. Two years ago, I went to a electrocardiophysiologist (EP) to check on my arrythmia, which seemed to be worsening.  Over the course of 20 years, I have had lots of tests, and the EP explained that my heart was in good shape, and I could choose whether or not to treat the palpitations with the Inderal.  Do NOT go off your medication without talking to your physician.  I felt great and was happy to have a healthly grasp of my "unique heartbeat."  I told myself (after the tests confirm) that I was fine, and that my heart "just beats to a different drummer."

Recently, my palpitations got really bad...and I was very short of breath.  Since that was a new symptom for me, me EP scheduled me for another echo, which indicated that my formerly, mildly leaky valve might now be severe.  She referred me to the CCF for a second opinion.  My doctor, from another major Cleveland hospital, believes that CCF is THE PLACE TO BE for people who may need valve surgery. The doctor at the clinic scheduled me for a TEE (11/00) which confirmed that the leak was NOT severe, but moderate. I was really glad to hear that.  However, I am back on the Inderal LA80....with 20mg for break-throughs.  The EP explained that 80 is a low dose, even for someone my size (100 #'s).  I am supposed to have an exercise echo around the first of the year.....Anyone know about those?  Be sure to keep up with your cardio, especially if you experience new symptoms.

Anyway, years ago when I started on the Inderal I was very tired, but after a few weeks or so, my body adjusted to it.  I have been back on for only a week, and it seems to be helping. It is a great medicine and it seems to keep my "ticker" in tune!  Good Luck!  I know what you are going through, but I can tell you, you will probably adjust....Oh, by the way, your feet may get reallllyyyy cold too!!!  Another side effect of the Inderal : )

I tried Tenorman and after one pill I was shaky all over....So, when you find a medicine that works for you...stick to it and listen to your doc!  As for those work presentations, not to worry....People are generally pretty understanding if you explain that you are in the process of taking a new RX and sometimes are not quite yourself.......***@****