I'm new to this and would appreciate your feedback

[Mooney]

Hi everyone. I am new here and glad to have found this forum. Here is a brief run down of my story, and I am looking for some advice on what to do next.

40 yr old male, no health issues, no medications. About six months ago started to feel my heart beating noticeably when trying to sleep. Also felt some chest pangs or pains now and then. I bought a BP monitor and it showed my pressures somewhat elevated, 130’s over 70’s and 80’s. I didn’t really do anything about it, and the symptoms were quite mild so I just dismissed it as stress.

Fast forward to end of June, I was en route to a client meeting and REALLY felt the heart beating fast and strong. A real pounding. It lasted a good hour or so and subsided. But that was enough to freak me out somewhat, so I made an appt to see my PCP.

He examined me, did EKG, everything fine, but then when listening to my heart he says “how long have you had this murmur?” Say what?? No one ever mentioned it before…so he sends me for blood work and an echocardiogram…blood work fine, the echo showed "left ventricle and right ventricle normal in size and function. Both atria normal. Bileaflet mitral valve prolapse, posterior greater than anterior. Moderate MR. Mild TR. Trace PR. No pericardial effusion.". I am told this is not a big deal, many people have it, suggests I keep up the exercise, no restrictions, but since this is a new murmur he is referring me to a cardiologist…

So I start reading about MVP on the internet…maybe not a smart thing to do as there is a lot of conflicting info out there…in mid July my chest pains increase…my arms and legs become numb…I get scared…but my cardio appt is still a month away and I cant get in sooner…BP is spiking and one night I just cant take it – I’ve got chest pains, arm pain, left arm pain, face numbness, palpitations and I go to the ER. They kept me overnight and did a pretty good work up – chest x ray, more blood & urine work and a stress echo. All come back fine, I am told it’s “just” MVP and I am to go home and follow up with the PCP.

About 2 weeks later I do see the cardiologist, he takes history of my symptoms, prescribes Norvasc 2.5mg per day since my BP is a little on the high side (130/80). Wants to see me again in four months, tells me to keep exercising, this is no big deal, it’s “just” MVP. He says there is nothing that can be done about it, just monitor it.

Well the chest pains continue and actually increase pretty bad. The palpitations are the worst ever and last for days and days. After 18 days on Norvasc I start experiencing the shortness of breath, and that’s frightening. It is worse at rest, I don’t even seem to have it when I exercise. SOB is one of the side effects on the Norvasc label that says “discontinue immediately” so I stop taking it. The SOB continues for a couple of days and then subsides. I have not had it for over a week now.

I report all this to the cardiologist and they put a holter on me for 24hr. I do not have the results of this yet but I was told over the phone by the nurse there was nothing of concern. Cardio wants to see me tomorrow to review and talk about my symptoms.

So, I am looking for some advice on what to do next. I feel like I do not know what questions to ask my cardiologist, and wonder if any of you who have MVP and who have symptoms - what should I be asking or expecting of my cardiologist at this point?

Here is a short list of some questions I have:

-If my MVP is “moderate” – why do I have symptoms?
-Was the SOB indeed a result of Norvasc?
-Since my MVP seemed to reveal itself suddenly as “moderate” should I be concerned that it may quickly go “severe”?
-Are there any other tests I should have?

All comments welcome.

 

[carolinemc]

Be sure to have copies of all the information you have found on the internet, some might be outdated, but any good resources are good, such as webmd, mayo clinic, the American Heart Association, etc. Reliable sources is the best. And then sit down and write down all the symptoms you have had, the heart beating fast, if there is shortness of breathe, chest hurting and how long it lasts. And then on another sheet of paper, write down questions for the doctor, such as test results and what does it mean, treatments and how long, what does all the other problems mean to you as your health and well being is concerned. Have a good doctor to answer questions and help educate you on what is actually going on is for you. You have to be proactive in your health care and treatment and education on the heart problems will help you in the long. One question that has to be asked here, does heart disease or problems run in your family. Going over health problems that run in your family will help also. I am sorry that this is so long, but I had learn all this also on my own. But it all helps in the long run. You will be fine tomorrow and you just talk to the doctor. He/she is there to help, if not, go find another one. Let us know how you come out. Later.

 

[tobagotwo]

There are a large number of possibilities.

You may have coronary artery disease. A Coronary Calcium Scan (Heart Scan) might help to diagnose that (far more effective at diagnosis than a "stress test"). Just because you have a moderate valve issue doesn't mean it's the only cause of your symptoms.

You may be having anxiety attacks, triggered by a number of different stressors, and centering on your recent diagnosis (the results of which are not really bad, based on your post).

You may have an undiagnosed heart rhythm issue. While the cardiologist undoubtedly did an EKG on you, he might try putting a Holter monitor on you to test you for arhythmias over the course of a day or more.

The amount of Norvasc was very small. While it could possibly cause the SOB, it's not the most likely outcome. High blood pressure by itself is usually without symptoms. It would be interesting to note what level your BP was at when it was spiking and you had the angina.

I wish you good fortune in determining what is causing your symptoms.

 

[AgilityDog]

Even with moderate MVP, you should be monitored on an ongoing basis, with an echo at least every 12 months. You may be stable here for a long time, or the valve may continue to deteriorate, necessitating surgery for repair or replacement.
Keep a calendar of your symptoms in between visits, and take it with you when you go, along with your questions.

 

[Jkm7]

Hi Mooney,

Happy you found us an sorry you are experiencing all these symptoms and the stress it it creating.

I wonder if anyone has suggested a stress test, preferably a nuclear stress?
If you have CAD in addition to MVP, it needs to be discovered.

Hope you have a successful appointment.
Please let us know how it goes.

 

[Mooney]

Hey thanks everyone for the guidance and reassurance. You guys are great.

Couple other data points - some history of heart issues in the family. My Dad (75 yrs) recently had a stent put in with blockage around 70%. My Mom is fine but has had high BP for years (like 40). My Grandfather died young age 62 from a heart attack which I understand was caused by an "enlarged heart".

There is history of anxiety - I can't tell you how many times over the years my Dad was rushed to the ER with heart attack like symptoms, tested up the wazoo and discharged with no further action required. I am definitely feeling anxious when I have an episode of my symptoms, and the mere discovery that something was amiss with my heart freaked me out significantly. I even feel anxious just typing this and talking about these things. But, my symptoms today are less severe in some ways compared to July when I was given the MVP diagnosis. But still they are there and they have indeed affected my lifestyle. I am trying to learn how to cope with this.

My BP spikes seem to occur every 7-12 days and last for a few days at a time. Then they subside. When it spikes it is like 155/90. Normal for me seems to be 125/75. When my BP spikes I feel it coming on. It starts with a bit of tingling in my left wrist. Then just a general feeling of unwellness. Like I don't want to do anything else.

Could an anxiety attack, or a spike in BP attributed to anxiety, last for days? Could a spike in BP cause the MVP symptoms to become more pronounced and noticeable?

Sorry for all the questions...really appreciate you guys taking the time to respond. Having read through this forum over the past couple of weeks I know my issues pale in comparison to what some of you are having to deal with.