I have MVP and a murmur as well. I never put the two together with the anxiety. My anxiety/depression seems to have gotten worse with age.

I have MVP but didn't know it could be a possible cause of my anxiety. Is that true? Ebaby, I noticed you are from CT also. Whereabouts? I am near Middletown.

Yeah look it up on google. It says that people with MVP are more prone to anxiety/panic.

I'm near Granby...near Mass line

I would be curious to ask the doctor why that could be? I am going to do some research. I don't have MVP but I am going to ask and read!

I don't have MVP, but I have a tricuspid valve murmur. It's rare, I believe. Literature says it is more common in drug abusers - not me. Anyway, I hadn't heard that a murmur makes you more likely to have anxiety. That's interesting.

I also suffer from Mitral Valve Prolapse and have found it challenging to find any local support groups. Does anyone out there have syptoms relating to MVP?

I was diagnosed with MVP when I was in my early 20's but I came down with this damn anxiety thing last year (when I was 53, for the love of God). Never knew there was a link. But I do know that a rush of adrenalin fakes a panic attack. I was driving in my car a few months back and a car cut me off and we almost crashed, of course my adrenalin shot up but I thought it was anxiety, when I realized that it was just adrenalin I calmed myself right down. Something to think about.

hmmm that's interesting cuz i have a heart murmur...and panic attacks...hmm

I also have a heart murmur (benign) and anxiety attacks!

I would like to know if I have MVP but the tests I've had done have been inconclusive. I had a treadmill stress test last year. When it got to thee uphill part of the test I became light headed and short of breath. the doc said, oh she has anxiety and just told me to sit down...very cold...like I was wasting his time having this test when I was just a looney...so now I just have tha daily palpitations with no answer...

I have MVP and have suffered from anxiety all my life. I never knew that there could be a link.

I just found out I have MVP as well. Dr. did not say anxiety was associated with this. I go to the doctor on Monday. I am going to ask him while I am there.

I have mitral valve prolapse and panic attacks also. My father also had both. I do think that it causes anxiety.

When I was checking for it they said I had Mitral valve bowing. Not a complete prolapse but it was present. That is so strange.

Mitral valve prolapse--MVP--is a well recognized, clinical entity with a reported prevalence of 4% to 18%. According to The Framingham Heart Study, 7.6% of women and 2.5% of men have MVP. Others report an incidence as high as 18% in women, and 12% in men. The wide range is due to gender, age, and ethnic background of the subjects, along with the use of different diagnostic criteria. How many people with symptomatic mistral valve prolapse syndrome is unknown.

Mitral valve prolapse is believed to be inherited, with a greater expression of the MVP gene in females. Although people with MVP come in all shapes and sizes, there are physical features commonly associated with MVP. These include: pectus excavatum depression of the breast bone, scoliosis curvature of the spine, abnormally straight thoracic spine straight back, arm span greater than height, unusual joint flexibility, and low body weight.

Mitral valve prolapse has been around for a long time. In fact, symptoms similar to MVP syndrome were traced to the sixteen hundreds. MVP has been known by a variety of names. These include: irritable heart, soldier's heart, the effort syndrome, Barlow's Syndrome and DaCosta's Syndrome. British solders during the mid eighteen hundreds noted symptoms of fatigue, palpitations, shortness of breath, chest pain and were unable to perform demanding physical tasks. This was a major cause of medical disability. Similar findings were noted during the Civil War, World War I and World War II.

William Osler, an eminent physician, noted the similarity between symptoms associated with irritable heart mentioned by others and those occurring in the general population, particularly in women. Some physicians believed the problem was not the heart, but one of a psychiatric nature. As technology advanced, so did the understanding of mitral valve prolapse. The 1980's saw the development of the classification of mitral valve prolapse into: Anatomic MVP and the MVP Syndrome.

Normal Mitral Valve



Anatomic Mitral Valve Prolapse

Anatomic mitral valve prolapse is an abnormality of the mitral valve leaflets, or supporting chords, or both. These structures allow the leaflet(s) to prolapse--buckle back into the left atrium during the heart's contraction--ventricular systole. Anatomic mitral valve prolapse is usually associated with structural changes whereby: the valve can be described as floppy; the chords--supporting structure--may thin, thicken, or lengthen. The exact cause of these structural changes is theoretical and not clearly understood.

Prolapse of the Mitral Valve



Several mechanisms can produce MVP. When the cause of the prolapse cannot be identified, it is described as primary mitral valve prolapse. When MVP is a consequence of other conditions, it is known as secondary mitral valve prolapse. One example of secondary mitral valve prolapse is prolapse caused by endocarditis--a bacterial infection of the valve. Please note that this book will discuss primary mitral valve prolapse.

Mitral Valve Prolapse Syndrome

Primary anatomic mitral valve prolapse is frequently associated with a constellation of symptoms. These symptoms are listed below. Individuals with one or more of these symptoms are referred to as having the mitral valve prolapse syndrome MVPS. The term MVP syndrome refers to the occurrence of, or coexistence of, symptoms unexplainable on the basis of the valvular abnormality. Thus, the symptoms associated with MVPS are not due to the valve itself. They are believed to be based on various physiological changes. These are discussed later.

MITRAL VALVE PROLAPSE SYNDROME

COMMON SYMPTOMS

Chest pain
Fatigue
Palpitations, extra heart beat
Lightheadedness, dizziness
Shortness of breath
Anxiety and/or panic attacks
Headaches
Low exercise tolerance
Mood swings

Characteristics of the Symptoms

Chest Pain

The chest pain associated with MVP presents itself in many ways. The pain may be brief in duration, or persist for hours. People describe the pain as sharp, heavy, shooting, sticking, or as pressure. At times it can be incapacitating, occurring repeatedly. Often the chest pain is atypical of angina pain caused by narrowing or constriction in the coronary arteries. Sometimes, however, the pain mimics angina.

Many MVPers believe chest pains signal a heart attack. MVPS is not known to cause a heart attack. In general, severe narrowing and blockage of a coronary artery that supplies an area of heart muscle with blood causes a heart attack. This may lead to permanent damage of a portion of the heart muscle. MVPS neither narrows nor blocks coronary arteries, nor causes permanent damage to the heart muscle.

You ask, "How can I be sure the chest pain is not from coronary artery disease?" The answer to this relates to your original diagnosis. To first determine if heart disease is present, your physician considers your cardiovascular risk factors such as: age, sex, family history, blood lipid profile, smoking history, as well as your symptoms and results of diagnostic testing. Periodically, he follows up with testing such as an exercise stress test to reassure you the chest pain is not caused by coronary artery disease.

Fatigue

Fatigue is usually present to some degree. It may be episodic and severe, or relatively constant. Usually fatigue begets more fatigue the less you do, the less you feel like doing. The cause of the fatigue may relate to blood volume changes noted with exercise, to a high resting heart rate, or to other physiological factors to be discussed shortly.

Palpitations, Extra Heart Beats, Forceful Heart Beat, Pounding Heart, Heart Flutter

People describe palpitations extra beats as a pounding sensation in their chest. Others say they feel a flipflop or fluttering. Arrhythmias disturbances in the heart rhythm such as atrial extra

beats (PACs), or premature ventricular extra systoles (PVCs) can cause palpitations. While some people feel each beat, others do not notice them. Often, after extra beats, people have a sensation that their heart stopped for a few seconds.

Skipped or extra beats are very common among MVPers and the general public. Sometimes they occur following the use of caffeine, alcohol, tobacco, or certain medications. Other times, emotional stress may cause extra beats. Sometimes they happen for no apparent reason. In any case, these beats are relatively common, and should not be a cause for alarm. An explanation of the heart's electrical system may help to understand extra beats.

(For further information about extra beats and various arrhythmias, see Taking Control: Living with the Mitral Valve Prolapse Syndrome.)

Lightheadedness, Dizziness

Lightheadedness, dizziness, or both can occur when first standing up. This feeling is usually associated with a sensation of a forceful heart beat or palpitations. These symptoms may be related to decreased intravascular volume and metabolic neuroendocrine abnormalities.

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 cardiac heart, or pulmonary lung abnormalities.

Anxiety and/or Panic Attacks

Although the relationship is not clear, many MVPers suffer from anxiety or panic attacks. The symptoms described are more consistent with panic disorder, the anxiety disorder studied most often in MVP patients. People have recurrent, spontaneous anxiety attacks that consist of various combinations of symptoms similar to some MVPS symptoms. These symptoms include: fatigue, fainting, dizziness, chest pain, lightheadedness, rapid heartbeat, heart palpitations, and shortness of breath.

The degree and mechanism of association between MVPS and anxiety disorders remains unclear. While some believe the symptoms cause anxiety attacks, others believe extraneous factors trigger attacks. They may occur anywhere, at anytime, even in the middle of the night. Whenever anxiety attacks do occur, they are frightening.

Headaches

Headaches sometimes occur in the form of migraines and are accompanied by nausea and blurred vision. Some people describe their headaches as nagging or dull.

Other Symptoms

MVPers report other symptoms. Common ones include:

chronically cold hands and feet
gastrointestinal stomach disturbances
problems with memory or a feeling of fogginess
inability to concentrate
mood swings
problems sleeping
numbness or tingling of the arms or legs
arm, back, or shoulder discomfort
difficulty swallowing
lump in the throat

Frequently, these symptoms are frightening, discomforting, frustrating, annoying and incapacitating. Certainly, they affect one's life style.

Expect symptoms to be more intense during emotional stress, when you are overly tired, after unaccustomed physical activities, during menopause, or during menstruation. It is not unusual for the symptoms to disappear spontaneously for months--even years and reappear again.

The following table lists factors that increase the intensity or frequency of MVPS symptoms. Data collected at the Mitral Valve Prolapse Program of Cincinnati (MVPPC), along with responses to the questionnaire in the first edition of Taking Control were used to compile the list.

FACTORS THAT CAN INCREASE THE INTENSITY OR FREQUENCY OF MVPS 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
Lying on the left or right side
Menses
Menopause

Symptoms begin at any age. Most people, however, notice symptoms between the ages of 20 to 30. The exact cause likely relates to several factors and remains unclear. Often, MVPers who have been without symptoms, become symptomatic after an illness, injury, pregnancy, or emotional stress such as a divorce. While symptoms occur more in females, many also occur in male MVPers. Frequently, chest pain, palpitations, fatigue or anxiety attacks initially prompt them to seek medical help.

Many people with MVPS believe the more symptoms they have, the more severe is the prolapse buckling back of the valve. This is not the case. In the mitral valve prolapse syndrome, there is no correlation between the degree of prolapse and the severity of the symptoms.

METABOLIC NEUROENDOCRINE ABNORMALITIES IN MVPS

Research studies support the belief that certain physiological abnormalities may be responsible for MVPS symptoms. Not everyone's symptoms, however, are explained by these physiological alterations. The presence, degree, and type of involvement of the various physiological systems sometimes vary.

These physiological abnormalities include: autonomic nervous system dysfunction, decreased intravascular blood volume, and renin-aldosterone regulation abnormality. These systems are interrelated but separately discussed.

For further information, see Taking control: Living with the mitral valve prolapse syndrome.