Questions about Mitral Valve Prolapse

[Sara__0__0]

  I was diagnosed with MVP several years ago.  I am now 20 years old and a little concerned.  I use to be an active athlete until I started attending college.  Since then I can fit in little or no exercise.  This past year I have started having some of the symptoms of MVP.  I went to my cardiologist and told him that I was having some of the symptoms, like chest pains, and that they seemed to really happen sparatically.  He prescribed Nitro pills for the pains.  I questioned this because it seemed so strange to me at the time.  He told me that I could fill the prescription or not.  It depended on me.  I have not filled it and I am really starting to question his diagnosis.  I am wondering if I should get a second opinion.  I have had MVP all my life and have never had any symptoms until now.  Quite frankly I am a little frightened by it all.  The dizziness, pains, breathlessness.  It is quite sudden to me.  Should I get a second opinion?  And if I do, who should I go to?
  Another question.  Is it bad if someone with MVP misses a meal?  I ask this because I have missed meals before, snacked in between, and have felt lousy for the rest of the day.  It seems if I miss a meal I have more of the symptoms of MVP and overall feel terrible.  Thank you for your time.

[CCF Cardio MD - MTR]

Dear Sara, thank you for your question.  Mitral valve prolapse (MVP) results when the mitral valve leaflets have extra tissue which makes the leaflets more pliable.  The mitral valve thus prolapses into the left atrium during the systolic phase of the cardiac cycle.  MVP can be diagnosed with a stethescope but requires an echocardiogram to confirm the diagnosis.  For reasons that are not well understood, people with MVP have a higher incidence of atypical chest pain (so called because there are no coronary artery blockages to cause chest pain), palpitations (due to an increased frequency of premature beats), and generalized symptoms like fatigue and shortness of breath.   These symptoms may be due to an enhanced neural output from the heart, but there do not appear to be any structural cardiac defects to explain these symptoms.  Thus, even though these symptoms are quite a nuisance, they do not portend an adverse prognosis.  Thus, I recommend to people with MVP to develop coping strategies to minimize these nuisances and to not worry about "bad" things that may happen to them because of the MVP.  You certainly could get a second opinion on the MVP but it's doubtful that there are any therapies that would relieve your symptoms.  Thus, I don't think you should take nitro pills and I don't think that missing a meal should have any impact on your symptoms.  Overall, I hope you can overcome these symptoms and your fears.  Good luck!

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