Mitral Valve Prolapse, exercise and heartrate

[Carrie]

Hi, I just joined this board and after reviewing the FAQ's, I didn't see an answer to my questions, so I thought I'd ask here.

I'm a 34 year old woman with mitral valve prolapse. I have no idea of the degree of severity or anything else of that nature. It was diagnosed by echocardiogram when I was in jr. high school. (In 7th grade I was one of the best runners in my gym class, but the next year I could not even do the minimum number of laps in the time allotted and I had a very fast resting heartrate, so off to the doc we went.) Anyway, they told me that it was no big deal and that it shouldn't affect me, other than I could probably never compete in any sports that required aerobic activity such as running or swimming.

I joined the YMCA a few months ago and have been going to a dance aerobics class on a regular basis and I'm getting frustrated at my heartrate. It seems impossible to keep anywhere near the "target heartrate". I'm always well above. Even when I get on the elliptical machine and I'm going slowly (3-3.5mph) the machine has to tell me to slow down as my heartrate gets up to 160 bpm. Now, I've got women in this class with me that are at least 20 years older than me and heavier and they aren't even breathing hard or breaking a sweat. (I am a high-normal weight for my height, by the way) I huff and puff and can't carry on a conversation and when we stop to check our pulse, mine is racing and above what it's "supposed" to be. At least I've stopped turning an alarming shade of red all over my face and body...

What I want to know is, if I keep at this, do you think I will eventually be able to do this class without feeling like I need an oxygen bottle or that my heart's going to pop out of my chest any minute? I can't ride a bicycle up even the mildest incline without being completely winded and needing to stop, I have to stop for breathers when hiking up steep hills, even climbing a flight of stairs causes my heart to speed up noticeably, etc, etc.

Oh, and the other thing is that everything I read about exercising to burn fat wants you to keep your heart rate kind of low so that you burn fat and not carbohydrates. Obviously that is a huge challenge for me. Is that necessary do you think? I am torn between trying to exercise more gently to try to stay in the "fatburning range" OR exercising vigorously and hope that my heart will become more conditioned and will handle the same exercise more and more easily.

Thanks for reading and I welcome any advice you might have to offer. I hope I don't come off as whiney or complaining...it's just that doctor's seem to shrug off my concerns or questions and I really want to improve my cardiovascular fitness to as normal as possible (or better, even) and they can't/won't tell me if that's possible or how I should go about it or what's too much too soon. I do count myself very lucky that I don't require surgery like so many of you folks do/did.

 

[geebee]

Carrie,

I guess my first question is, "are you being followed by a cardiologist"? A lot can change from junior high school to 34 years old. If you do have a cardio, what is his/her response to your symptoms. If you are not seeing a cardio, I think that should be your next step. Sometimes prolapse can be very serious and we do have a couple of members who have required surgery.

Being generally out of shape can cause similar symptoms and they will usually improve with time. However, given your history, I don't think you should pursue this without more information from a cardiologist.

 

[Karlynn]

Welcome Carrie,
My first question is the same as GeeBee's - got a cardio and are you doing regular check-ups with him/her? If not, then do so before you do any more working out.

If you are being followed by a cardio, are you having regular echo tests? If not, now would be the time to get one. If you have a recent one, post the measurements here - we have some very knowledgable members that can give you their opinion on how severe or mild your particular situation is. If you have a doctor that tells you "Oh, lots of people have MVP. There's nothing to worry about." Or "You're to young to have problems related to MVP." - get another doctor. Yes, lots of people do have MVP - but a doctor with that attitude will most likely not be willing to believe your symptoms are valve related. I had a doctor try to put me on Valium because he thought I was blowing my symptoms all out of proportion.

People with MVP do tend to have their heart rates jump up really quickly, so your description of how fast yours goes up doesn't surprise me. The big question is whether or not it's because your valve has become worse recently, and this you definitely need to get checked out.

 

[Georgia]

I was diagnosed with mvp at age 29 because of arrythmias and tachycardia. I had to take digoxin and beta blockers to get my heart to settle down. The regurgitation from the mvp can cause your heart to become sensitive and causes the rapid and erratic heartbeats.

Ditto for going to the cardiologist. It's a necessity in your case. I had a pcp who didn't follow up on my cardiac problem and I ended up in trouble.

I suspect that if you get on some medication you'll have better luck with keeping your heartrate where you want it.

 

[Carrie]

No, I haven't been seen by a cardiologist. I went to the doctor last year because my heart was keeping me awake (everytime I would lie down, it felt like it was beating more forcefully, even to the point where the book on my chest was moving up and down) and it was hard to fall asleep because of the pounding. They did an EKG which was normal and sent me home. I also sometimes have what feels like an "extra" beat that's really hard. I visualize it as a (it's ok to laugh at this, it's goofy!) little donkey in there that suddenly kicked me hard in the chest, and when that happens, for a second it feels like I can't breathe. Then it's fine.

I guess I'll make an appointment with my M.D. and ask for a referral. You are right, a lot can change in over 20 years. The thing that bothers me is that if it were just being out of shape, you'd think I'd see some improvement in 3 months of steady exercise, and I'm not that out of shape. I'm an active person and a size 8, I eat relatively healthfully and I'm in otherwise good health. Thanks for the input, and the suggestion to see a cardiologist. They really do seem to shrug it off and it made me feel like I was making a big deal out of nothing. I'll let you all know what happens and will keep reading the board in the meantime so I can learn some more.

**Edit** I also wanted to say thanks for making me welcome here among you and I appreciate your advice.

 

[geebee]

Carrie,

Valve problems, per se, do not show up on an EKG because they are not electrical. They can sometimes trigger electrical problems but the echo is the standard for measuring valve issues.

Insist on a referral (if your insurance requires one) and get this checked. Let us know what happens. I am sure you will end up with more questions.

Based on what you said about your lifestyle, I would agree that you should not still be having problems from "being out of shape". There is definitely something else going on.

Good luck.

 

[MelissaM]

Carrie,

Exercise intolerance, heartrate changes and palpitations (the donkey kicking you in the chest ) can be a sign that something has changed. For me, these were some of the biggest signs. At the time, I felt they were pretty subtle changes, but in retrospect, I can see my heart was trying to tell me something.

Time to get to a cardiologist!

Melissa

 

[maka]

Carrie
I can only echo what has already been said....please go to a cardiologist and I will add....make it soon. I also had a mitral valve prolapse diagnosed when I was very young and was told for many, many years not to worry. I had my regular check ups and one day a new cardiologist told me that I should have it operated before it got worse. It had developed severe regurgitation. Valve was repaired in August.
I?m definitely not an expert but your symptoms sound to me more heart related than being out of shape. If I were you I would stop the exercises until I see a good cardiologist

 

[Karlynn]

I would be a bit careful of a doctor that just does an EKG, knowing you have MVP, when you report the symptoms you did. I only say this because it seems that many doctors are quick to dismiss younger valve patients strictly due to age. They just can't wrap their minds around someone young having issues, if it's not something they specialize in. They assume only older people have heart problems. When I was 27 I had a doctor try to prescribe Valium to me because he thought I was conjuring up my symptoms because I was young.

Given your current symptoms when working out, I would advise that you not work out until you see a cardiologist and get an echo done. Don't put this off.

I know that this all probably frightens you, but you are better off informed about what your current state is.

Keep us posted, and let us know if we can answer any more questions.

 

[FranR]

Mvp

Mvp

Hi Carrie:

 

[carista]

Hi Carrie from a fellow Minnesotan!

I don't have problems with my mitral valve, so can't help too much, but I wanted to mention that before I had surgery I was told to keep my heart rate under a certain point and doing the elliptical I also felt like I was barely getting a workout before my heart rate would be up there. I don't think it has anything to do with you being out of shape and I also don't think that working out more or harder is going to help. I would definately see a cardiologist like everyone else has said. I would do it as soon as possible just because I think all the sympoms you're getting are for a reason.

Just so you know also, working out slow is fine and just as good for burning body fat, it just isn't as beneficial cardio wise. I would play it safe and not work out until you see someone. (If you do, taking it slow is just fine)

Good luck and welcome!

Carista

 

[FranR]

Mvp

Mvp

Hi Carrie: I'm a fairly recent member to this site but wanted to respond to you after reading about your symptoms/concerns. I had my mitral valve repaired almost 4 years ago (Feb.). After reading many postings on this board about various members' problems, I feel complelled to put in my two cents about my experience and give some advice. So here goes...like you I had a "weird heartbeat" especially when sitting or laying down. I brought it my doctor's attention and likened it to a 'backwards heartbeat'. I was diagnosed with MV prolapse and was followed for about two years with EKG's. I was told that this condition was very common in woman and nothing to worry about. After a while though I asked to see a cardiologist just to make sure everything was okay. The cardio seconded the diagnosis of MV prolapse and said he would monitor it, adding that I may "eventually need surgery." Surgery seemed so 'out there' for me as I never even had the flu, so I immediately went for a second opinion. It was the best thing I ever did. We are a former military family and my first cardiologist was a civilian (or regular) doctor. I decided to go to a military doc since I thought the first cardio just wanted my money by saying he needed to monitor me. But to make a long story short, the military doc told me that not only would I eventually need surgery but that I should have it as soon as possible before I actually needed it. His reasoning was that heart damage would eventually occur (in the way of enlargement) and I should repair the MV before any damage was done. So basically I had "elective" heart surgery...that is a term that sounds crazy, doesn't it. But here's my two cents - after being a member of this board for the past month and reading many, many posts about people's experiences/problems/symptoms, etc. I would venture to say that I was given expert advice about having surgery done before it was necessary. I had no damage/enlargement therefore my repair made my heart better than before. It was amazing to me how much better I felt after my surgery. I really didn't think I had any symptoms until after my repair and I was actually able to walk up a flight of stairs without breathing hard. I just always thought I was out of shape even though I'm thin. So my point is this...although MVP is not uncommon and many doctors will tell you it's nothing to worry about until you show severe symptoms or damage, don't wait to get it repaired. Obviously nobody wants to have the most major of surgeries, but if you can fix a problem before it becomes really serious my opinion is to do it. I realize that everyone has their own experience and views but I wanted to share mine with you and the rest of the members. Good luck to you and keep reading the posts. I know you'll find some great information here.
Fondly, Fran

 

[FranR]

Hi Carrie: I'm a fairly recent member to this site but wanted to respond to you after reading about your symptoms/concerns. I had my mitral valve repaired almost 4 years ago (Feb.). After reading many postings on this board about various members' problems, I feel complelled to put in my two cents about my experience and give some advice. So here goes...like you I had a "weird heartbeat" especially when sitting or laying down. I brought it my doctor's attention and likened it to a 'backwards heartbeat'. I was diagnosed with MV prolapse and was followed for about two years with EKG's. I was told that this condition was very common in woman and nothing to worry about. After a while though I asked to see a cardiologist just to make sure everything was okay. The cardio seconded the diagnosis of MV prolapse and said he would monitor it, adding that I may "eventually need surgery." Surgery seemed so 'out there' for me as I never even had the flu, so I immediately went for a second opinion. It was the best thing I ever did. We are a former military family and my first cardiologist was a civilian (or regular) doctor. I decided to go to a military doc since I thought the first cardio just wanted my money by saying he needed to monitor me. But to make a long story short, the military doc told me that not only would I eventually need surgery but that I should have it as soon as possible before I actually needed it. His reasoning was that heart damage would eventually occur (in the way of enlargement) and I should repair the MV before any damage was done. So basically I had "elective" heart surgery...that is a term that sounds crazy, doesn't it. But here's my two cents - after being a member of this board for the past month and reading many, many posts about people's experiences/problems/symptoms, etc. I would venture to say that I was given expert advice about having surgery done before it was necessary. I had no damage/enlargement therefore my repair made my heart better than before. It was amazing to me how much better I felt after my surgery. I really didn't think I had any symptoms until after my repair and I was actually able to walk up a flight of stairs without breathing hard. I just always thought I was out of shape even though I'm thin. So my point is this...although MVP is not uncommon and many doctors will tell you it's nothing to worry about until you show severe symptoms or damage, don't wait to get it repaired. Obviously nobody wants to have the most major of surgeries, but if you can fix a problem before it becomes really serious my opinion is to do it. I realize that everyone has their own experience and views but I wanted to share mine with you and the rest of the members. Good luck to you and keep reading the posts. I know you'll find some great information here.
Fondly, Fran

 

[Wise]

I would be a bit careful of a doctor that just does an EKG, knowing you have MVP, when you report the symptoms you did. I only say this because it seems that many doctors are quick to dismiss younger valve patients strictly due to age. They just can't wrap their minds around someone young having issues, if it's not something they specialize in. They assume only older people have heart problems. When I was 27 I had a doctor try to prescribe Valium to me because he thought I was conjuring up my symptoms because I was young.

Given your current symptoms when working out, I would advise that you not work out until you see a cardiologist and get an echo done. Don't put this off.

I know that this all probably frightens you, but you are better off informed about what your current state is.

Keep us posted, and let us know if we can answer any more questions.

I totally concur with Karlynn. I would still think my only issue was MVP unless I had some family history issues. Because of being monitored due to family history, I'm now being watched for MV & AV regurgitation. Given your symptoms, I'd definitely advise an appointment on the echo table.

Welcome to the site. Best wishes.

 

[Maureen]

Carrie...I know exactly what you are going through! I was diagnosed with MVP ( with regurg) at age 22, I have just turned 41. Initially I was told it was no big deal, don't worry about it but I was told to take antibiotics before dental work, surgery etc. After having a baby at 27 things started to go downhill. Shortness of breath, fainting/near fainting episodes. I have had a terrible time with cardiologists who take one look at me ( young, non-smoker, not overweight) and say I have nothing to worry about! The last guy I saw implied it was all in my head and wanted me to take valium....this was 5 minutes after he had met me for the first time. He was the first Dr ever to imply this and he has completely shattered my self confidence.

Over the years I have had several attempts at working out in the gym. I found I could walk quite quickly and for as long as I wanted but as soon as I set the machine to "incline" I was in trouble Heart rate would shoot up, gasping for breath and face turning that lovely red/purple colour! As for the exercise bike...1 minute on that and I was seeing stars. I explained all that in my last visit and the cardio's helpful suggestion was that I needed to go back to the gym and push myself harder.....I told him that if I did that I would pass out and that the gym staff wouldn't let me back in! His answer...he actually dictated a letter for me to give to the gym stating that there was no reason why I shouldn't exercise

This all took place last August and to be honest I was so upset afterwards that I have sworn not to go near a Dr for as long as I can. I know I'm being stupid but I just can't face it. I know that there's something wrong but I'm so afraid of meeting another cardio like the last one. I visited a friend last week who was sick in bed...after going up the stairs to her bedroom, I couldn't carry on a conversation with her.. I tried, but had to keep stopping for air. My sensible head says "this isn't right, go to the Dr" but my fear of not being believed is greater.

I suppose the reason I'm writing all of this is to say "please don't let them tell you it's nothing"....insist on an echo at least. I sincerely hope you are able to find a decent cardio who will listen to you.

 

[Carrie]

Ok, I made an appointment for 1/23 just to ask for a referral to a cardiologist. I've done more reading and it seems I should have had a least a couple more echocardiograms to monitor, just in case. I will insist on both the referral and the echo and will suggest a graded exercise stress test, since that is when my symptoms are the most noticable and bothersome. I'll let you all know what the results are.

- Carrie

 

[Karlynn]

Good girl!

You are your own best health care advocate and it pays to keep on top of things. Keep us updated.

 

[Georgia]

Maureen, I hope you've found a cardiologist by now. You simply cannot swear off doctors just when you need one the most. You shouldn't have the problems you have - you're too young. Many of us here have "doctor shopped" until we found one who takes us seriously (cit. ref. "Aussigal").

Women particularly are often brushed off as "hysterical." When I was in the hospital with congestive heart failure two weeks before my valve surgery, my pcp arrived with Ativan to "see if some of these cardiac problems are related to your anxiety." This was the same guy who'd entirely missed my cardiac problems, even tho I'd been diagnosed with mvp 20+ years before.

Please please please try another cardiologist. Furthermore, if you can, you should try to get copies of your medical records back to when you were first diagnosed wih mvp. I promise you'll eventually find someone who believes you.

And Carrie, good for you. You go, girl!!!!

 

[Carrie]

Ok, well I saw a regular doctor at my clinic today and she was able to hear it with her stethoscope. (They never could hear it before, but I also don't think they looked as hard. She could only hear it when she had me lean forward.) Anyway, I've got an echo scheduled for next Tuesday, then she wants to follow up with me and decide at that point if I need a cardio referral. I'm not sure at all what I'm hoping for at this point, lol...

 

[PJmomrunner]

Let's see...you've had diagnosed MVP for 20+ years and your GP is going to look at your echo report and decide if you need to see a cardio...? Sounds like you belong to an HMO.