Mitral valve prolapse (MVP) is a fairly common medical problem, probably genetic in origin. It is usually first diagnosed as a faint heart "click" or murmur, though it isn't a form of heart disease in the conventional sense. It is a relatively benign condition, although linked to a confusing array of seemingly unrelated symptoms, and is currently the most common valve disorder in industrialized nations since the risk of heart murmurs from rheumatic fever has been reduced. MVP is thought to affect 5% of the population, although the number of borderline cases may be much higher.
The mitral valve is one of the large valves of the heart whose function is to keep the blood flowing in one direction through the left side of the heart, and to prevent backflow of blood when the heart contracts. It is made up of two triangular fibrous membranes, thin but tough, which are attached to strong cords like parachute cords, in turn attached to muscles. When the heart contracts, the two leaves billow up to close off the opening between the upper atrium and the lower ventricle on the left side of the heart. "Prolapse" means that the two leaves are a little loose, a little floppy, so that the valve doesn't close as firmly as it might. It may close with a faint click, or may permit a tiny amount of blood to leak through, producing a heart murmur.
People with mitral valve prolapse are especially sensitive to all kinds of drugs and medications, and the idea that all patients with mitral valve prolapse should routinely receive antibiotic prophylaxis for dental procedures is no longer accepted by many.
Curiously, most of the abnormalities seem related to an underlying instability of the autonomic nervous system. This is the part of the nervous system that regulates the internal functions of the body such as blood pressure, heart rate, sweating, body temperature, gastrointestinal activity, and emptying of the urinary bladder. It is believed by some that the mitral valve abnormality is a physical trait that is a marker of an underlying condition – autonomic instability – that contributes to symptoms and can trigger panic attacks.
Women are far more likely than men to be diagnosed with mitral valve prolapse. Interestingly, there is even a typical body type for sufferers: a slender young female with long, tapering fingers and a model's figure. Men can have the condition as can people with a different physique, but the majority seem to fit the standard profile.
Heart murmurs can be diagnosed with echocardiography which uses ultrasound to create a picture of the chambers of the heart.
The prolapsing mitral valve is known to damage platelets and increase their aggregation. This work has been confirmed in several studies.
People with mitral valve prolapse (MVP) seem somehow to be 'wired' differently. Their autonomic response can be much more volatile and unstable so that normal stresses and surprises set off an exaggerated response, flooding their systems with stress hormones called the catecholamines. In fact, there may not be a specific stressor; people with MVP are intermittently and unpredictably awash in their own catecholamines. This leaves them alternately innervated and exhausted – "wired but tired" is a common feeling.
If the sympathetic nervous system of a person with MVP is aroused, they can suddenly feel crushing chest pain, with heartbeat racing and pounding. They may begin to hyperventilate, feel short of breath, and break out into a cold sweat. This may occur without warning or immediate threat. There can be sensations of chest pain, a feeling of doom or detachment, a fear of dying, or a desire to flee. If they don't know why this is happening, the symptoms themselves are scary, and the fear of the unknown can prompt an even greater release of stress hormones, driving them into the kind of meltdown of the autonomic nervous system called a panic attack. This is an intense and scary experience, the sensations of which can easily be confused with those of a heart attack. Once people experience this, they generally have a persistent fear of having another attack, which puts them on a "hair trigger", ready to respond to the slightest symptoms by releasing the very stress hormones that induce the panic attacks, thus escalating a new attack.
L-carnitine is an amino acid that acts as a shuttle for fat that is required for cellular metabolism and also acts to strengthen the heart. Dosage: 500-1,000mg two to three times daily. Acetyl-l-carnitine is a related nutrient that may be more bio-available. Dosage: 120mg three times daily.
Avoidance of artificial flavoring agents like MSG and Nutrasweet is considered an important part of any treatment plan by some doctors.
Some patients are told to take it easy, but a recent study found that moderate exercise can benefit individuals with this condition. Amongst women who exercised, the symptoms that saw the most improvement were chest pain, fatigue, dizziness and mood swings. Over-exertion can often increase the symptoms of mitral valve prolapse, so increase exercise levels gradually.
Oral magnesium supplementation can provide relief of mitral valve prolapse symptoms.
Techniques to block the feedback loops that can lead to panic attacks or hyperventilation can be learned and practiced to break the cycle of escalating symptoms. By performing a "reality check" you can learn to break the conditioned response you have acquired to your own physical symptoms.
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