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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chest Discomfort, Sharp Pain In Heart. Fatigue, Breathing Difficulty, Nausea, Vertigo. Symptoms Of Myxomatous Mitral Valve?

For most of this year I have been suffering on a daily basis with heavy/tight chest discomfort/pain along with runs of PAF and what I call missed or ectopic beats .Also from time to time during the week I get a sudden sharp pain in my heart. It is always in the same spot (4-5cms left of the sternum and at an 8 o' clock position on my left breast). Sometimes it doesn't last long but on other occasions it continues on for up to 10 mins or so at a lesser degree of pain level. Other syemptoms include fatigue or weariness, at times a feeling of difficulty getting enough breath in as opposed to being puffed or short of breath, sometimes slight nausea, slight vertigo and a feeling of anxiousness. I am female, 62 years young, retired, 5ft 3ins tall and weigh 57.5kgs. I don't smoke, am quite active, eat a healthy diet, drink very little coffee and only have the odd half glass of wine once a week to fortnight. Two years ago after a bout of the above chest and heartbeat problems which included a sudden onset of a 15 hour episode of nonstop AF with spontaneous return to normal sinus rhythm. I had an echocardiogram and ultrasound done on my heart and it showed I had a Myxomatous Mitral Valve along with blood tests, event monitor and ECG. Since then the above symptoms are present day day. I feel fine in the morning but after doing usual daily chores and as the day progresses, I notice symptoms occurring. I do wonder if these symptoms are to do with the MMV but have been told by my cardiologist on a several occasions now that it's nothing to worry about! I take cholesterol lowering medication (strong family history of high cholesterol). I am otherwise well and happy. I would appreciate it if you can shed any light on this matter as I do wonder if what I am experiencing is due to the MMV.
Many thanks.
Cecil.y
Thu, 31 Oct 2013
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Pediatrician, Cardiology,  's  Response
MMV is a pathological weakening of connective tissue. The term is most often used in the context of mitral valve prolapse, which is known more technically as "primary form of myxomatous degeneration of the mitral valve."
The degeneration occurs in conjunction with an accumulation of dermatan sulfate, a glycosaminoglycan, within the connective tissue matrix of the valve.
In many cases, the degeneration is limited to the mitral valve and follows a benign course. However,when associated with systemic diseases, like Marfan syndrome, the degeneration is more extensive and involves other heart valves. The valves can become sufficiently distorted to cause insufficiency and regurgitation. Myxomatous degeneration is the most common cause of pure mitral valve insufficiency, which belong to complications of MMV, the complications mitral regurgitation and congestive heart failure may, in turn, cause arrhythmias and atrial fibrillation that may progress and lead to sudden death. However, there is no evidence that a prolapsed valve itself contributes to such arrythmias. Generally, MVP is benign. However, MVP patients with a murmur, not just an isolated click, have an increased mortality rate of 15-20%. The major predictors of mortality are the severity of mitral regurgitation and the ejection fraction. Echocardiography is the most useful method of diagnosing a MMV.
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Chest Discomfort, Sharp Pain In Heart. Fatigue, Breathing Difficulty, Nausea, Vertigo. Symptoms Of Myxomatous Mitral Valve?

MMV is a pathological weakening of connective tissue. The term is most often used in the context of mitral valve prolapse, which is known more technically as primary form of myxomatous degeneration of the mitral valve. The degeneration occurs in conjunction with an accumulation of dermatan sulfate, a glycosaminoglycan, within the connective tissue matrix of the valve. In many cases, the degeneration is limited to the mitral valve and follows a benign course. However,when associated with systemic diseases, like Marfan syndrome, the degeneration is more extensive and involves other heart valves. The valves can become sufficiently distorted to cause insufficiency and regurgitation. Myxomatous degeneration is the most common cause of pure mitral valve insufficiency, which belong to complications of MMV, the complications mitral regurgitation and congestive heart failure may, in turn, cause arrhythmias and atrial fibrillation that may progress and lead to sudden death. However, there is no evidence that a prolapsed valve itself contributes to such arrythmias. Generally, MVP is benign. However, MVP patients with a murmur, not just an isolated click, have an increased mortality rate of 15-20%. The major predictors of mortality are the severity of mitral regurgitation and the ejection fraction. Echocardiography is the most useful method of diagnosing a MMV.