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Despite MVP being so common, it has left the white-coat brigade scratching its collective head.
"Before ultrasound detection, many milder cases were not even diagnosed," says Professor Celermajer.
He concedes that if everyone were to have an ultrasound, the reported incidence may be much higher.
"The good news is that MVP doesn't mean you have an increased risk of heart attack or disease. Some people with MVP have palpitations or chest pain, which may be annoying but are not generally a sign of anything sinister.
"A small number of patients have a leaky heart valve that might need surgery, but in the large majority of cases MVP is left alone." |
The heart-mind connection
But could it be that this simple heart defect is not so simple after all?
According to David Robertson, Professor of Medicine, Pharmacology and Neurology at Vanderbilt University in the USA, most people may never notice any symptoms of their leaky heart valve or ever know they have it.
But others are plagued by a range of mysterious and disturbing symptoms that arise from an out-of-kilter nervous system. This is known as the Mitral Valve Prolapse Syndrome (MVPS) or dysautonomia, which is essentially MVP with a vast array of symptoms that could include one or more of the following: rapid heart beat, chest pain, thyroid problems, heightened sense of smell, palpitations, tender breasts, PMS, low blood pressure, anxiety (such as fear of flying or driving), fatigue, mood swings, irritable bowel and cold hands and feet.
"People with dysautonomia may also have slightly reduced blood volume, which explains why they can get dizzy when they stand or experience a faster heart beat or palpitations," says Professor Robertson.
Bianca Martin, a 26-year-old events co-ordinator from Cronulla in Sydney, was once hospitalised with crushing chest pain.
"They couldn't find any cause for the pain and sent me home," she recalls. "It took many visits to many doctors before I finally had an ultrasound that identified a leaky heart valve. I am double-jointed, was constantly cold and had lots of sleep problems due to anxiety. I hated flying and worried about everything.
"I was so relieved my illness had a name because for so long they had been telling me that there was nothing wrong. I finally felt like I'd proved I wasn't lying!"
Bonnie, who now runs the world's largest support group for the condition, The Society for Mitral Prolapse Syndrome, says while dysautonomia is not usually life- threatening, it can affect you.
"Once people are diagnosed they feel much better knowing that it's not all `in their head'."
Ways of seeing
Many doctors in Australia refuse to acknowledge a link between the leaky heart valve and dysautonomia.
"At this stage, there isn't enough conclusive medical evidence to say that MVP is linked to dysautonomia," says Professor Celermajer. "Most cardiologists believe that the patient might be anxious about their heart symptoms rather than having an underlying anxiety problem in the first place." But he agrees practitioners should keep an open mind.
Psychiatrist Professor Ian Hickie from Beyond Blue (www.beyondblue. org.au) is more straightforward. "Many cardiologists tell someone who is anxious not to worry about their chest pain. But this is the most unhelpful thing a doctor can say to someone whose life is being destroyed by worry or sleepless nights."
He says that specialists may wrongly dismiss patients as hypochondriacs before seeking further explanation which can account for problems such as MVPS.
"Cardiologists and psychiatrists need to take a less blinkered view of medicine and start thinking outside of their own speciality."
He says there's an increasingly strong connection between how anxiety disorders and the sympathetic nervous symptom, which govern the flight or fight response, can affect our heart.
"Millions of people front emergency rooms every year with panic attacks, once thought to be harmless. We now know this not to be true. Particularly in people with pre-existing heart conditions, panic attacks can actually trigger a heart attack and kill.
"We also know that people with depression also have a greater risk of heart disease, possibly because they smoke and drink more but increasingly, mood factors seem to be involved too.
"People who have been diagnosed with MVP-related anxiety should not ignore it. At the end of the day, while the valve may be harmless, their anxiety could kill them."
For more information see the Society for Mitral Prolapse Syndrome website, www.mitralvalveprolapse.com.
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