Palpitations? Pounding? Panic Attacks? You Might Have Mitral Valve Prolapse! -- Mitral Valve Prolapse and Thyroid Disease / Thyroid Disease Information Source

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Palpitations? Pounding? Panic Attacks? You Might Have Mitral Valve Prolapse!
Mitral Valve Prolapse and Thyroid Disease

by Mary Shomon

If you are experiencing heart palpitations, heart pounding, dizziness, sleeplessness, or panic attacks, and there doesn't appear to be an explanation for it, you may have mitral valve prolapse syndrome, or MVP syndrome. Recent medical research has found that the prevalence of mitral valve prolapse is substantially greater in patients with autoimmune thyroid disorders such as Graves' Disease and Hashimoto's Thyroiditis. One medical reference that supports this finding includes the research reported in the journal Cardiology.

Major Symptoms of MVP include:
Pounding, fast heartbeat
Palpitations
Fatigue
Weakness
Low tolerance for exercise
Chest pain
Panic attacks
Headaches, migraines
Sleeplessness
Dizziness, fainting
Intestinal problems
Shortness of breath

While the relationship between autoimmune thyroid disease and MVP is established, the reason behind this is not readily explained, and there doesn't appear to be substantial research on the subject to date. We do know, however, that autoimmune thyroid disease predisposes you to either have or develop MVP syndrome, so it's worth checking into if you have symptoms that are not resolved by being euthyroid (having a normal TSH.)

According to the Heart Surgery Forum, MVP is the most common heart valve abnormality, with estimates ranging from 2 million or more Americans diagnosed with this condition, and most are women (about 80%). MVP syndrome also has a strong hereditary tendency, although the exact cause is unknown.

First, let's look at what the mitral valve actually is. The mitral valve is one of the heart's four valves. Valves are like doors, and the mitral valve opens and closes between the left atrium (upper chamber) from the left ventricle (lower chamber and pumping chamber).

The closure of the valves in the heart is what makes the characteristic heartbeat sound.

The mitral valve has two flaps. Normally, the mitral valve allows blood to flow only in one direction. Both flaps open when blood is flowing from the left atrium and filling the left ventricle. Both flaps then close tightly when the left ventricle contracts and pumps the blood out to the body.

Mitral Valve Prolapse (MVP) is also known as:
Click-murmur Syndrome
Barlow's Syndrome
Balloon Mitral Valve
Floppy valve syndrome

But when you have MVP, one or both valve flaps are enlarged. When the heart contracts or pumps, the flaps don't close smoothly or evenly. Instead, part of one or both flaps collapses backward into the left atrium. This sometimes allows a small amount of blood to leak backward through the valve and may cause a heart murmur.

Symptoms

Symptoms of MVP most regularly reported include:

Pounding, fast heartbeat (the medical term is "tachycardia").
Irregular heart beat, "palpitations," also feelings of "heart flutter" or extra heart beats. Usually these are harmless. Rarely, potentially serious heart rhythm abnormalities may cause palpitations, requiring further evaluation and treatment.
Fatigue, weakness, tiring easily, and having a low tolerance for exercise. These are the most common complaints. There are theories that people with MVP may have imbalances in their autonomic nervous system -- it regulates heart rate and breathing -- that cause inadequate blood oxygen delivery to the working muscles during exertion, thereby causing fatigue.
Chest pain. Chest pain can be sharp or dull, lasting from a few seconds to several hours. The chest pain with MVP rarely takes place during or after exercise or exertion.
Panic attacks, anxiety attacks, and depression are associated with MVP. Like fatigue, these symptoms are believed to be related to imbalances of the autonomic nervous system.
Headaches and migraines
Sleeplessness
Dizziness or fainting spells, lightheadedness especially when first standing up.
Intestinal problems - such as irritable bowel syndrome.
Shortness of breath. This is usually described as the inability to take in a deep breath. It may occur at rest or with activity. The shortness of breath has not been found to be related to lung abnormalities.
Chronically cold hands and feet.
Problems with memory or a feeling of fogginess, difficulty concentrating.
Numbness or tingling of the arms or legs.

Diagnosis and Treatment

MVP can often be detected by a doctor during examination of the heart. MVP can be confirmed with an echocardiogram. The majority of patients with mitral valve prolapse have no symptoms, no problems and, therefore, need no treatment other than an annual or semi-annual follow-up exam. However, those who have leaky prolapsing valves need antibiotics to prevent infection of the valve (called encarditis) during certain surgical or dental procedures likely to cause bleeding. Typically, this involves one or two doses of an antibiotic -- i.e., oral amoxicillin and erythromycin as well as intramuscular or intravenous ampicillin, gentamycin, and vancomycin -- at the time of the procedure. Patients with more dramatic symptoms are sometimes given beta- blockers. such as atenolol (Tenormin), metoprolol (Lopressor), and propranolol (Inderal). Only in rare, serious cases is surgery indicated, for repair or replacement of the mitral valve.

Factors That Can Increase the Intensity or Frequency of MVP Syndrome Symptoms

According to Dr. K. A. Scordo's book, Understanding the Mitral Valve Prolapse Syndrome, you can expect MVP symptoms to become more intense during emotional stress, when you are overtired, after unaccustomed physical activities, during menopause, or during menstruation. And, it's not unusual for the symptoms to disappear spontaneously for months--even years and reappear again. The following are some specific factors that can increase the intensity or frequency of MVP Syndrome symptoms:

Emotional stress
Excessive fatigue
Unaccustomed physical activity
Being anxious or nervous
Caffeine
Medicines with stimulants
Sweets
Being in a hot, dry environment Dehydration
Flu, cold, or other illnesses
Lack of sleep
Alcohol
Smoking
Skipping meals
Rushing around
Having a menstrual period
Menopause

My Experience:
I've always had fluttering heartbeat feelings, palpitations (especially after caffeine), shortness of breath, and other mitral valve prolapse (MVP) symptoms, but my regular doctor had never heard anything unusual. My MVP was discovered by an internist during a physical. He prides himself on picking up hard-to-define murmurs, and listened to my heart for a few moments, and detected the characteristic "click" of a prolapsing mitral valve. A trip to the cardiologist for an echocardiogram confirmed the murmur. The main thing I was told to do? Take antibiotics per his instruction before and after dental work, and let any doctors know that I had MVP before surgeries so they can administer antibiotics. I also received a prescription for Atenolol, a beta-blocker. The cardiologist said I should take it if I was having palpitations that were noticeable or prolonged. I rarely have had to use it since the diagnosis, but I do try to minimize my caffeine intake, as this seems to be the thing that really aggravates the MVP for me.

For additional information MVP, check out the following links:

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