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Other names: Norpace CR
A USER’S GUIDE OF YOUR HEART: MITRAL VALVE MATTERS
Your heart has four valves that make sure blood flows in the right direction. They open when blood pulses against them, and close immediately afterward to stop blood from flowing back. The mitral valve controls blood flow from the atrium, the upper chamber of the heart, to the ventricle, which is the lower chamber.
For a percentage of the population, however, the mitral valve poses special concerns and possible problems. Some people, twice as many women as men, are born with a congenital heart defect known as mitral valve prolapse. For such individuals, the leaflet or flaps which comprise the valve become enlarged and misshapen. This results in improper closing, allowing blood to regurgitate back into the atrium. When a physician listens to the heart with a stethoscope, he or she can hear this regurgitation, which sounds like a click or murmur.
For many patients, mitral valve prolapse presents absolutely no symptoms whatever. They may even be surprised to hear that they have the condition, which is often discovered during routine examinations.
Other individuals experience a variety of symptoms including heart palpitations or skipped beats. Some notice light-headedness, dizziness, or shortness of breath. And occasionally mild chest pain may occur. A few patients may suffer anxiety, sometimes even panic attacks, owing to the condition.
Patients diagnosed as having mitral valve prolapse (MVP) can often relieve symptoms with a program of exercise. In a study published in the April 1991 issue of the American Journal of Cardiology, 32 women had frequent symptoms that had been attributed to MVP. Half of them were assigned an exercise training session three times a week; the other half did no exercise. By the end of 12 weeks, the exercisers had a significant decrease in anxiety, chest pain, fatigue, dizziness and mood swings compared with the non-exercisers. They also had a general increase in the feeling of well-being.
For most patients, simply knowing what may have been causing their symptoms is sufficient to put their minds at ease. Most of those with this condition live a completely normal life and require no medication whatsoever.
But prolapse patients are at greater risk of infections of the valve called bacterial endocarditis. Doctors will frequently recommend as a preventive measure that such patients take antibiotics prior to undergoing any surgical or dental procedure which can introduce bacteria into the bloodstream.
Very rarely mitral valve prolapse can lead to serious heart beat disturbances which can result in stroke or even sudden death. Bear in mind, however, that such occurrences are very rare. Your doctor is in the best position to put your condition into proper perspective.
If examination with a stethoscope reveals a mitral valve problem, or, for that matter, an abnormality of any of the heart valves, you’ll probably be asked to have an echocardiogram performed, a procedure by which the anatomy of the heart and its structures can be studied via sound waves. Today an echocardiogram can be conducted at the same time as a treadmill test to see how the heart and its valves perform during exercise.
Finally, about five per cent of patients with mitral valve prolapse will require surgery. In some instances the valve can be repaired, and in others it will be replaced with an artificial valve.
Rheumatic fever can damage heart valves, making them stiff and incapable of closing properly. Though the illness may occur in childhood, valvular damage isn’t immediately seen and may not show up until well into adulthood.
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