Re: mitral valve prolapse

Posted By eama on June 07, 1998 at 05:04:30:

In Reply to: mitral valve prolapse posted by jeff on May 20, 1998 at 00:59:11:






: I was diagnosed with MVP several years ago. After taking several different types of beta-blockers over the years,I still have terrible angina. It is so bad at times that I can't breath. I have awaken in the middle of the night with crushing pain that worsens when I try to lay down again. I went to the hospital once and they told me I was having arrhythmias, my heart was skipping beats, then they put me on more medicine and sent be home. When I went to my regular family physician, he told me not to worry about it,that I was too young (36), my cholesterol level was fine, and physically I was in good shape. That this was just part of having MVP. My family history is filled with heart disease and I worry that maybe my physician is over-looking something or maybe I should just try another medicine. I really don't know what to do if anything. Will I really have to deal with this pain all the time regardless of what I do?



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Dear Kelly,
Indeed, Mitral Valve Prolapse syndrome (MVP) can be a cause of chest pains.  Pain from MVP can be concerning and uncomfortable, but is associated with no adverse prognosis.   The pain you describe is atypical for ischemic coronary artery disease (the pain that causes heart attacks).  However,  some
patients can experience chest pain from spasm of the coronary arteries, despite the absence of any significant atherosclerotic deposits.  
It would be reasonable, given the severity of your symptoms, to perform an exercise stress test, possibly with adjunctive thallium imaging techniques, to assess the remote possibility that this pain is coming from traditional coronary artery disease.  I expect such a test will be negative (normal).  However, this does not confirm whether you're suffering from what is known as "variant angina", or coronary artery spasm.  To address this latter possibility, you could undergo a coronary catheterization with the specific goal of ruling-out "spasm" as the source of your symptoms.  Otherwise, to avoid the catheterization, your doctor might consider empirically prescribing a type of medication known as calcium channel  blockers, which are often successful in treating this condition.
Best of luck.  Information in the Heart Forum is for general purposes.  Specific diagnoses and therapies can only be provided by your physician.