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Doctors' Answers to "Frequently Asked Questions" - Mitral Valve Prolapse (MVP)

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Mitral Valve Prolapse [posted 1/14/99]
Question: I would like to know what are the usual and customary treatments for Mitral Valve Prolapse?

Answer: Well, they are only to treat the symptoms. Beta blockers are the usual ones to block extra beats, etc. Occasionally, antidepressants or benzodiazepines for the concurrent anxiety. Antibiotics are often recommended for dental/surgical procedures depending on the amount of leakage.

Mitral Valve Prolapse & Atenolol [posted 12/08/98]
Question: My doctor recently put me on Atenolol for high blood pressure and mitral valve prolapse. I'm 36 and in relatively good health otherwise. I do, however, have migraine headaches that I take Excedrine (acetaminophen/caffeine) for. Thus far, this is the only medicine that I've found to work with a consistent results. I also suffer from allergies to pollens at various times of the year. My doctor told me what not to take for stuffy/runny nose, and to stay away from caffeine (which I've done for s number of years), but neglected to tell me what to use when I have these types of attacks. I've been  suffering all night long and now all day as well, and still no call back from my doctor.  I need to know if it is all right to continue taking the Excedrine while I'm taking the Atenolol, and what in the world do I take for congestion and runnsrc=ose/watery eyes? Thanks for your help! Thanks again.

Answer: Caffeine would tend to cause more irregular heart beats and should be avoided. However, you need to try it and see your individual reaction. You may not have much problem with the caffeine. Any of the OTC drugs will cause irregular heart beats. But, with most patients with MVP, these are a nuisance, not a medical emergency. However, get a Atrovent Nasal Rx from your doctor for the next time. Pretty effective with minimal cardiac effects.

Mitral Valve Prolapse Concerns [posted 11/24/98]
Question:  I am a 32 year old female who was diagnosed with a heart murmur when I was little and later was told that I had mitrovalve prolapse. I was always told that, apart from having to take antibiotics before going to the dentist, there were no precautions that I needed to take. I was told it was normal to have occasional irregular palpitations and chest pains. My question is how do I distinguish between normal chest pains and palpitations, given my condition, and the kinds I need to be concerned about?  

Answer: Hard to know which always raises anxiety with MVP patients. However, patients with MVP usually outlive those without it unless the leakage is increasing. You can decrease the palps with a beta blocker (at the price of some fatigue).  

Dexedrine For MVP [posted 10/20/98]
Question: I have MVP. Recently my doctor prescribed Dexedrine to help fight the chronic fatigue the MVP produces. I still feel dizzy and lightheaded at times. Is this a fairly effective therapy in MVP treatment? Is there a drug that will help fight the plaque build-up around my valve? Does lactic acid play a role in the chronic fatigue? Thank you.

Answer: This drug is not indicated in MVP and might help produce arrthymias. I would also have serious concerns about your physicians judgement. There is not usually a plaque build up around heart valves, although they can degenerate over time. In terms of the lactic acid, no one is clear what the etiology of CF is, but, off hand I doubt that lactic acid has any role.

Mitral Valve Prolapse Syndrome [posted 7/17/98]
Question: I have heard that there is a condition known as Mitral Valve Prolapse Syndrome, which includes symptoms including anxiety, irritable bowel syndrome, migraine headaches and extreme fatigue. Is Mitral Valve Prolapse Syndrome a recognized and medically accepted syndrome and, if so, could my "saggy" valve cause the Syndrome?

Answer: MVP has been described for years and about 10% of women do have MVP. It seems that the connective tissue throughout the body is "different" and the MVP is only one manifestation of this genetic variation. Migraine headaches and irritable bowel are not part of this syndrome. The valve does not cause the systemic problems seen with MVP, rather different connective tissue does. Anxiety, fast heart beats, excessive response to caffeine and like drugs, hyperextendable joints, a tendency to small breasts are part of the syndrome.

Mitral Valve Prolapse and Pseudoephedrine [posted 7/16/98]
Question: I am interested in learning what possible effects taking medications such as Pseudoephedrine or teraphendrine (Seldane or Seldane-D) can have on someone who has mitral valve prolapse.

Answer: Any of the drugs similar to pseudoephedrine can produce irregular heart beats. This is similar to caffeine or chocolate in its effect. Seldane and other antihistamines can produce irregular heart beats, but by a completely different mechanism. There should be no special sensitivity to Seldane (or any other antihistamine) with MVP. There will be increased sensitivity to pseudoephedrine and like drugs.

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