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Sunday, January 25, 2009


Mitral valve prolapse is so named because a very slight posterior motion is seen as the mitral valve closes. The mitral valve is designed to undergo significant movement as it opens and closes during cardiac action, or flexibility. It is not harmful and causes no damage to the heart or to the body. The array of troublesome and often frightening symptoms which may be seen from time to time in people with this valve movement is not due to this extra motion, or prolapse, of the valve. The associated symptoms which might include dizziness, numbness, chest pain or pressure, palpitations, anxiety, sleeplessness, gaseousness, bowel symptoms or actual diarrhea, and mood swings have been termed Mitral Valve Prolapse Syndrome.
These symptoms are not due to the prolapse of the valve itself.Many Individuals have come to recognize that the prolapse of the mitral valve ( the other valves of the heart can similarly prolapse as well) is actually just a marker, or an identifier, for a person with this complex of symptoms, and not the prime cause of the symptoms.Most often, these and other symptoms are clearly related to the excessive drive or hyper- function of the autonomic nervous system, which can be thought of as the "automatic" nervous system. This system controls functions of our body, such as pulse rate, blood pressure, breathing, digestion, blood sugar, the size of our pupils in dark and light, and the dilatation of our peripheral blood vessels under hot conditions, and contraction in cold conditions. It also is related to our state of anxiety and sleep/wake conditions. It is both the stress nervous system and the digestive nervous system, having two states which are normally fine-tuned and balanced.We are quite familiar with what our body does under stress, such as before giving a talk, a performance, an examination, an important interview, or before an anticipated stressful event. We often have sweaty, yet cool hands, hard pounding of the heart, slight breathlessness, dryness of the mouth, increasing frequency of urination, looseness of bowels, and if measured, some increase in blood pressure. This familiar pattern of behavior of our body is due to excessive adrenaline and similar hormones from the autonomic nervous system as a result of the stress. The anticipated event has "gotten our juices flowing." This is the response of our body to acute stress. After the event is over, sensations experienced prior to it generally subside. We have met the stress and dealt with it, diffusing and halting the stress hormones responsible for it.However, certain individuals with perhaps more moderate levels of stress continue to experience bodily sensations of the stress syndrome, though on a more chronic basis. It is as if the stress hormones remain turned up, or our bodies respond to these hormones with continuing stress symptoms. These individuals seem to have a more reactive or hypersensitive autonomic (stress) nervous system. This had led some researchers to call the syndrome "DYSAUTONOMIA." It is of interest that many patients with mitral valve prolapse have (or are subject at some point over the years to have ) symptoms of dysautonomia. Similarly, a certain percentage of patients with dysautonomia or mitral valve prolapse syndrome have other related findings, such as scoliosis; curvature of the spine, usually mild, or bony chest abnormalities (such as pectus excavatum). Many women have fibrocystic breast problems and excessive premenstrual symptoms (PMS), and even temporomandibular joint problems, or TMJ.Thus, it seems clear that the tiny movement of the heart's mitral valve is not causing all of these varied manifestations of a syndrome encompassing many bodily functions. Perhaps there is good reason then to call this complex of symptoms DYSAUTONOMIA or Mitral Valve Prolapse Syndrome to indicate our understanding of the fact that there is far more involved here than a small amount of prolapse of the mitral valve.

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