Re: Mitral Valve Prolapse

Posted By CCF CARDIO MD-APS on September 30, 1998 at 10:35:24:

In Reply to: Mitral Valve Prolapse posted by Kathy Ruxton on September 29, 1998 at 13:50:13:






I am a 28 year old female diagnosed with MVP one year ago. Echo showed "mildly thickened and/or redundant" MV and "trace to physiologic" mitral valve regurgitation. I have chest pains from time to time. They are clearly on the left side. A Holter showed several hundred PVCs. I've never passed out or felt dizzy or been short of breath. And other than MVP, I am perfectly healthy. Several questions:
1 - What causes the chest pain? What type of pain should I be concerned about?
2 - What does "trace to physiologic" regurg. mean?
3 - I know that the mitral regurg. can sometimes get worse in patients, and that makes me anxious. What is the likelihood of the regurgitation getting worse in MVP? 1 percent? 15 percent? Will exercise make it more likely to get worse?
4 - Lately I am having slight tingling in my right foot for no apparent reason. It's more pronounced when I stand up. Should I be concerned?
Thank you so much. This is my second question. I hope I'm not abusing the privilege. This website has answered so many questions for me.



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Dear Kathy,
Yours is a very organized question, and you should not ever think you are abusing the priviledge, we are
glad to answer questions, more questios, and further explain if necessary.
Now, if we understood in anyway how it is that MVP is related to the many chest
pain syndromes that MVP patients feel, we would be on our way to treatment.  Unfortunately, we do not
understand this chest pain syndrome at all.  The pain that you should be concerned about is a heaviness in
your chest, indigestion type pain that is new or related to exertion and not eating, and shortness of
breath-these are all pains that may signify that the heart vessels are blocked and it could be the warning of
a heart attack.  Some MVP patients undergo stress tests annually in order to evaluate their chest pain syndromes
that seem indistinguishable from worrisome pains.  You should discuss your risk factors for coronary artery disease
(which I presume are little given your age), as well as your pain so that you can come to some kind of agreement as
to the best way to evaluate and treat your pain.
2."trace to physiologic regurgitation" means that your mitral valve leaks a little.
And by physiologic, they mean it leaks at no more than the average person(who is without MVP.)
3.About 10-15% of patients with MVP will progress to have worsening regurgitation, due to worsening thickening
of the valve over time.  Often these patients will need surgical repair and or replacement before the leakage gets
so bad that it makes their heart fail.
4. Since MVP patients may be at a very, very slightly increased risk for emboli (clots), there is a very
small chance of stroke like syndromes.  Thus you should be concerned about momentary numbness or weakness of
the arms,legs,or face; or momentary loss of vision, but the tingling you speak of sounds more like an orthopaedic
problem than a brain problem.  In general any new symptom should be addressed.  Consider anyway that it sounds
like your leg and or foot is falling asleep?
5. the one question you didn't ask was about taking antibiotics before seeing the dentist to avoid the likelihood
that your abnormal valve will get infected, please discuss this with your doctor also.
I must leave you with this statement, you are very healthy, and this MVP is minor and simply needs to be followed
on a regular basis(like every year); the majority of people with MVP never get worse, never get infections, and very few
ever have stoke like syndromes.  Good Luck.
Informtation 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).