Mitral Valve Prolapse: Truth and Fiction

"There is nothing to fear except the persistent refusal to find the truth." – Dorothy Thompson

One chapter of my recent book, "courageous fighting," describes my experience with a patient named Emma Jorgenson. Shortly after sitting in my office, I said: "I hope you can help me, doctor. Other doctors continue to say that my symptoms are all in my head."

"What seems to bother you, Emma?

"Disturb me?" My problems are not just bother me, kill me. If we do nothing to help me, I die. I know. "

"What kind of symptoms you have?"

A deep sigh, Emma shifted uncomfortably in his chair. "I do not know where to start," he said. "Every time I try to explain my symptoms to a doctor, he only moves his eyes and told me that this is not nothing to worry about. "Emma bowed and began to flow.

I took the box of tissues on my desk and handed it to Emma. "We to understand how we can help. Why not start early? "I said." What was your first sign?

"One night, for nearly three years, I awoke with a throbbing sensation in my chest. My heart was beating so fast I thought it was out of my chest. Then I began to nausea and dizziness. I called Mr. Cahill, my family doctor who is also my gynecologist, and when I went to see the next day, they found a tumor in the stomach. She said she had to have surgery to remove it. "

"What have you found?

"A cyst on my ovary. No was nothing serious, but after the operation, the bombing and dizziness became more frequent, so she sent me to a neurologist. "

"Why would a neurologist?

"I read an article that said that the three most common symptoms of brain tumors were headache, nausea and dizziness, then I asked him to send me to a specialist. He has done many scans and electrical tests and said everything was fine. He prescribed a tranquilizer, but I knew that this was not the intention to solve my problem. "

Does it help tranquilizers?

"A little earlier, but my symptoms have worsened. When the beating started, as well as dizziness and nausea, my hands start to shake and to sleep. After Meanwhile, numbness spread to the face. The whole area around the mouth of losing all feeling, except for a tingling cable. I sure I will have a stroke. It was then that Mr. Cahill referred me to an otolaryngologist.

"An ear nose and throat?"

"It's true. She thought my dizziness may be due to an inner ear problem. The revised and said he was not sure what was happening, but I needed an operation to get to the bottom of the itself. But I was too scared. Besides, I had recovered from ovarian surgery, and my wounds do not heal right, so my gynecologist told me I could wait before having another operation. "

Emma's story WinCE me. He had unknowingly been in the maze of modern medicine. Each specialist consulted by their symptoms through the prism of their own specialty, ordered the inevitable battery of tests, and treated with a pill or a procedure without a diagnosis. Medication is the fifth leading cause of preventable death in the United States.

"Why did you send to me?"

"Le I do not think an inner ear problem, and should be a kind of heart disease. After all, how a problem of inner ear pain chest ago and shortness of breath?

"Chest pain and shortness of breath? You said nothing about it."

I told him I explained that there are several Causes for chest discomfort, and each has a set of features revealing. For example, in patients with pleurisy, an inflammation of the lining of the lungs, pain occurs when you breathe deeply. With an inflammation of the sac surrounding the heart called pericarditis, pain increases when the patient lies down and improves when sitting and leaning forward. In patients with blocked coronary arteries, discomfort occurs during physical activity such as walking or climbing stairs. A lump or rupture in the aorta, the body's main artery, also features.

All these possibilities and more must be carefully explored by delving into the nuances of Emma chest pain and palpitations and shortness of breath. Emma's description of his chest pain was not compatible with a common cause of chest pain, but it was important not to neglect other serious possibilities. In patients with pleural friction sound can be heard with a stethoscope over the lungs during a deep breath. Pericarditis sounds like sandpaper rubbing in synchrony with the heartbeat. congenital malformations and abnormalities of the heart muscle valve murmurs to provide testimony and other characteristic signs on physical examination.

Despite a rapid pulse of Emma, his blood pressure was normal and lung seemed clear. On examination, heart, heartbeat normal, but when I put the stethoscope on your chest, the diagnosis is made immediately apparent.

When the heart of the contract of Emma, a series of loud sounds were audible click. My patient had a mitral valve prolapse.

The heart is divided into two parts, each with four bedrooms. Both above are called atria, and the latter two are the ventricles. The right atrium and ventricle receives oxygen-depleted blood from the body and sends it to the lungs where it restores the oxygen content. The left atrium receives blood then rejuvenated by passing along the left ventricle. The powerful left ventricular cavity, and then pumps the body content.

The atria and ventricles are separated from each other by valves. The tricuspid valve is on the right side of the heart, while the mitral valve on the left. When the mitral valve opens, which is the blood of the left atrium, through the valve, and enters the left ventricle. As the ventricle contracts left, the valve closes, preventing blood going to the left atrium.

The mitral valve has two leaflets or flaps, each in form a parachute. Normally, the two brochures about in unison, but in patients with mitral valve prolapse, or the valves are too large, the agreements to attach to the heart are too long, or connective tissue of the structure are more elastic than normal. In all cases, one or two of these balloons or prolapse-flops in the left atrium. The characteristic crack heard when listening to the heart is caused by the noise of the valve prolapse valve in atrial chamber, like a parachute in the wind.

mitral valve prolapse is a relatively common, occurring in two-and-five percent of people United States. It is particularly common among premenopausal women aged between fourteen and forty. There was a considerable amount of speculation on how to produce abnormalities of the valve, but recent research has shown that a genetic predisposition syndrome. Between twenty and fifty percent of parents of patients mitral valve prolapse also have the syndrome.

Echocardiograms are useful tool to evaluate patients with mitral valve prolapse suspicion. The test confirms the diagnosis by showing the layers of the valve prolapse. Furthermore, the presence and severity of reflux of blood valve through the ventricle into the atrium can also be detected. In the case of Emma, I have not heard the whispers suggesting the presence of a witness drain.

Patients with mitral valve prolapse often have symptoms that mimic diseases such as heart attacks and heart rhythm abnormalities, but the vast majority of women, the condition is not dangerous or life threatening. Most relatives of patients with mitral valve prolapse showing a valve unit in echocardiography are completely free of symptoms.

The reason for chest pain, palpitations, shortness of breath that occur in some patients with mitral valve prolapse has never been understood. In the absence of a more scientific explanation, it was speculated that their nervous systems are programmed to respond to too much stress. For reasons unknown, has soared to react to circumstances threatening, as if they were dangerous. This imbalance is called dysautonomia.

After putting my stethoscope in my shirt pocket, patted me gently on the shoulder of Emma. "I have great news! Its symptoms are caused by a condition Benign called mitral valve prolapse. "I guess that Emma could be released. Instead, the diagnosis has increased her anxiety to the point where it becomes inactive.

Although the symptoms of mitral valve prolapse are divers and can be extremely serious, it is important to note that for the vast majority of people with the condition is not dangerous or threatening. Studies have shown that increased levels of adrenaline flows as substances explain pain symptoms in the chest, palpitations, breathlessness, anxiety and Panic Attacks that affect people with the problem.

Prospects for the vast majority of people with prolapse mitral valve is excellent. My experience has been that people with debilitating symptoms gradually feel better over time. They realize that their symptoms do not cause a heart attack or sudden death, and the same symptoms are made while less disabling. As one of my patients said: "I just put the pain in her purse and was my business. "

For most patients, the only treatment needed is the use of prophylactic antibiotics before surgery and various types of dental care, but is used in those with a leaky faucet. Medications, including a group of medicines called beta-blockers "can be useful for monitoring debilitating symptoms. Exercise, healthy diet and relaxation techniques have been helpful in controlling symptoms.

And as Emma, she had a transformational experience that changed his life. No longer restrained by fear, she developed a new extraordinary serenity and a new appreciation of life.

He also gave a new life goal. Emma became a patient care consultant and a valuable member of our team of health care, using his experience as a resource to assist our patients in the grip of fear.

About the Author

Richard Helfant, MD, is a Harvard-trained cardiologist. His book
Courageous Confrontations
includes this story about a woman with exaggerated fears about
mitral valve prolapse
.

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