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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.
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.
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.
Heart murmurs can be diagnosed with echocardiography which uses ultrasound to create a picture of the chambers of the heart.
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GLOSSARY
Benign: Literally: innocent; not malignant. Often used to refer to cells that are not cancerous.
Candidiasis: Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge.
Catecholamine: Any of various amines (as epinephrine, norepinephrine, and dopamine) that function as hormones and/or neurotransmitters.
Gastrointestinal: Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.
Hormones: Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Migraine: Not just a headache, but a disorder affecting the whole body, characterized by clearly defined attacks lasting from about 4 to 72 hours, separated by headache-free periods; progresses through five distinct phases. Prodrome: experienced by about 50% of migraineurs and starting up to 24 hours before the headache - changes in mood, sensory perception, food craving, excessive yawning, or speech or memory problems. Aura: experienced by about 15% and starting within an hour before the headache - disruption of vision (flashing lights, shimmering zigzag lines, blind spot) or sensation (numbness or 'pins and needles' around the lips or hand), or difficulty speaking. Headache: usually pulsating and occurring on one side of the head, it may occur on both sides of the head and alternate from side to side. Muscles in the neck and scalp may be tender; there may be nausea and the desire not to eat, move, see or hear. Resolution: the headache disappears and the body returns to normal. Resolution may occur over several hours during sleep or rest; an intense emotional experience or vomiting may also end the headache. Postdrome: After the headache stops, the sufferer feels drained, fatigued and tired. Muscles ache, emotions are volatile and thinking is slow.
Nervous System: A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.
Panic Attack: A brief, irrational episode of fear that is perceived as so real that an individual may be driven to escape from the place or situation where it occurs. The attack is sudden and increases in severity until it leaves, usually within ten minutes. Panic attack symptoms are numerous and involve both mental and physical signs and symptoms. A panic attack can occur in other anxiety states such as agoraphobia and with certain activities and places. It may occur spontaneously without an apparent cause.
Sympathetic Nervous: Sympathetic nervous system: Portion of the autonomic nervous system that is generally associated with “flight or fight” reactions by increasing blood circulation and respiration and decreasing digestion.