Mitral Valve Prolapse and Thyroid Disease

Palpitations? Pounding? Panic Attacks? You Might Have Mitral Valve Prolapse!

Doctor listening to a patient's heart with stethoscope
Hero Images/Getty Images

Medical research has found that the prevalence of mitral valve prolapse (MVP) is substantially greater in patients with autoimmune thyroid disorders such as Graves' Disease and Hashimoto's thyroiditis. It's estimates that 2 million or more Americans are diagnosed with this condition, and most are women (about 80%).

While the relationship between autoimmune thyroid disease and MVP is established, the reason behind this is not readily explained, and there doesn't appear to be substantial research on the subject to date.

We do know, however, that autoimmune thyroid disease predisposes you to either have or develop MVP syndrome.

MVP syndrome also has a strong hereditary tendency, although the exact cause is unknown. 

What is Mitral Valve Prolapse?

Let's look at what the mitral valve actually is. The mitral valve is one of the heart's four valves. Valves are like doors, and the mitral valve opens and closes between the left atrium (upper chamber) from the left ventricle (lower chamber and pumping chamber). 

The mitral valve has two flaps. Normally, the mitral valve allows blood to flow only in one direction. Both flaps open when blood is flowing from the left atrium and filling the left ventricle. Both flaps then close tightly when the left ventricle contracts and pumps the blood out to the body.

When you have MVP, one or both valve flaps are enlarged. When the heart contracts or pumps, the flaps don't close smoothly or evenly.

Instead, part of one or both flaps collapses backward into the left atrium. This sometimes allows a small amount of blood to leak backward through the valve and may cause a heart murmur.

Mitral Valve Prolapse (MVP) is also sometimes referred to as: 

  • Click-murmur Syndrome
  • Barlow's Syndrome
  • Balloon Mitral Valve
  • Floppy valve syndrome 

Symptoms of Mitral Valve Prolapse

The major symptoms of MVP include:

  • Pounding, fast heartbeat (the medical term is "tachycardia").
  • Irregular heart beat, "palpitations," also feelings of "heart flutter" or extra heart beats. Usually these are harmless. Rarely, potentially serious heart rhythm abnormalities may cause palpitations, requiring further evaluation and treatment.
  • Fatigue, weakness, tiring easily, and having a low tolerance for exercise. These are the most common complaints. There are theories that people with MVP may have imbalances in their autonomic nervous system -- it regulates heart rate and breathing -- that cause inadequate blood oxygen delivery to the working muscles during exertion, thereby causing fatigue.
  • Chest pain can be sharp or dull, lasting from a few seconds to several hours. The chest pain with MVP rarely takes place during or after exercise or exertion.
  • Panic attacks, anxiety attacks, and depression are associated with MVP. Like fatigue, these symptoms are believed to be related to imbalances of the autonomic nervous system.
  • Headaches and migraines
  • Sleeplessness
  • Dizziness or fainting spells, lightheadedness especially when first standing up.
  • Intestinal problems - such as irritable bowel syndrome.
  • 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 lung abnormalities.
  • Chronically cold hands and feet.
  • Problems with memory or a feeling of fogginess, difficulty concentrating.
  • Numbness or tingling of the arms or legs.

If you are experiencing heart palpitations, heart pounding, dizziness, sleeplessness, or panic attacks, and there isn't an obvious explanation for it, you may have mitral valve prolapse syndrome, or MVP syndrome. 

Diagnosis and Treatment

MVP can often be detected by a doctor during examination of the heart. MVP can be confirmed with an echocardiogram. The majority of patients with mitral valve prolapse have no debilitating symptoms or complications, and therefore, need no treatment other than an annual or semi-annual follow-up exam.

Note: in the past, prophylactic antibiotics were recommended to MVP patients before dental work and other procedures, but that is no longer considered necessary.

Patients who have more significant symptoms are sometimes given beta- blockers drugs, as atenolol (Tenormin), metoprolol (Lopressor), and propranolol (Inderal). Only in rare, serious cases is surgery indicated, for repair or replacement of the mitral valve.

Factors That Can Increase the Intensity or Frequency of MVP Syndrome Symptoms

According to Dr. K. A. Scordo's book, Understanding the Mitral Valve Prolapse Syndrome, MVP symptoms may become more intense during emotional stress, when you are overtired, after unaccustomed physical activities, during menopause, or during menstruation. And, it's not unusual for the symptoms to disappear spontaneously for months--even years and reappear again. The following are some specific factors that can increase the intensity or frequency of MVP Syndrome 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
  • Having a menstrual period
  • Menopause

My Experience

I've periodically had fluttering heartbeat feelings, palpitations (especially after caffeine), shortness of breath, and other mitral valve prolapse (MVP) symptoms, and eventually, my MVP was discovered by an internist. He prides himself on picking up hard-to-define murmurs, and listened to my heart for a few moments, and detected the characteristic "click" of a prolapsing mitral valve. A trip to the cardiologist for an echocardiogram confirmed the murmur. The main thing I was told to do? I received a prescription for Atenolol, a beta-blocker, to take as needed if I was having palpitations that were noticeable or prolonged. I rarely have had to use it since the diagnosis, but I do try to minimize my caffeine intake, and avoid pseudoephedrine (Sudafed), as both seem to really aggravate the MVP for me.

Continue Reading