Your questions are answered by Phillip C. Watkins, M.D., Retired director and co-founder of: The Autonomic Disorders and Mitral Valve Prolapse Center
New MVP Clinic
2470 Rocky Ridge Rd Suite 200
Vestavia Hill, AL 35243
Disclaimer: The answers to these questions are not intended to give personal medical advice. That should be obtained from your own physician. There is no substitute for a complete medical evaluation by a competent doctor. Only he/she knows your personal medical history.
Q. Can thousands of daily untreated PVCs harm one's heart?
A. Patients who have PVCs may well have thousands of them daily. The average number of heartbeats per day is around 100,000 or so. Certainly several thousand of those may be PVCs. It will not harm the heart per se, although you may experience symptoms of an irregular heartbeat. Of ourse, if this develops into a more dangerous type of rhythm problem, that would be a different situation.
Q. I always have a fast heartbeat. Even the slightest movement can cause me to have tachycardia. Will this eventually wear my heart out?
A. This will not damage or "wear out" your heart. It is uncomfortable and very unpleasant to have this occurring. This is generally due to increased adrenaline from the dysautonomia. A beta-blocker or similar type of medication should control this and help symptoms. You probably would be experiencing a lot of fatigue unless this was treated with a beta-blocker.
Q. I have been diagnosed with MVP/dysautonomia and OCD. I was wondering if OCD is comon in people with mitral valve prolapse and dysautonomia?
A. We also see quite a few patients that have features of OCD, and it is a problem in some patients who need treatment for other symptoms of dysautonomia, as it can interfere with that treatment. Whether the actual incidence is any higher for OCD patients with dysautonomia is not clear. I do not know of any studies that have been done, but it would be most interesting and helpful. My guess is that there is probably some correlation.
Q. I would like to know if one antidepressant is better than another for SAD. I am already becoming depressed and do not want to go through another bad winter.
A. It is certainly getting close to SAD problems. Patients begin noticing this usually but September, if not earlier. The treatment, of course, is the same regardless of the time of year, but it is certainly getting into the time of year when patients will notice symptoms. The best antidepressant is the one that works for you. Talk to your doctor about this. He will have a better idea, knowing your particular symptoms.
Q. 15 years ago I was diagnosed with mitral valve prolapse. I recently had an echocardiogram, and my doctor said I do not have MVP now. I told him I still have many symptoms, but he does not want to treat me for MVP now.
A. The amount of prolapse that you see on an echo of the mitral valve does not necessarily correlate at all with the symptoms that are present, but you still may need to be treated for the symptoms that you do have.
Q. The antidepressant I am on has made a great difference in my life. I feel great. However, it is causing me unwanted sexual side effects. Should I add another drug to the one I am already on, or try a new antidepressant altogether?
A. There is definitely a difference in the degree of sexual side effects, depending on the type of medication that you're on. The symptoms are due to changes in serotonin, in particularly the serotonin level dropping during the fall and winter months. This can be alleviated by adding another medication that is not serotonin-related. It is probably simply easier and better to find a new SSRI that does not have the same side effects. There is a definitely a difference in the degree of side effects with the various SSRI medications
Q.I have diagnosed with MVPS/d, panic disorder, and depression. Does this mean I am mentally ill?
A. This does not mean that you are mentally ill. It simply means that you have these disorders related to your MVP and dysautonomia and require treatment. It is certainly not unusual and not indicative of any serious "mental" change.
Q.Are we born with MVP and/or MVPS/D?
A. No we are not born with dysautonomia, but we are born with the tendency to inherit it for it to show up sometime in the future. Virtually all of the patients we see have got some type hereditary familial relative in the family that also has dysautonomia.
Q. Why is ti when I fly I have more symptoms such as dizziness, palpitations, and lightheadedness?
A. Flying has an affect on problems with dysautonomia mainly because of the change in blood volume with the altitude. This is not at all uncommon to have problems flying and you should load up on fluids before and while in the air, which should help alleviate this.
Q. Even thoughtThe American Heart Association no longer recommends taking antibiotics before dental procedures, my dentist insists that I do take them before cleaning. Have you heard of this?
A. There really is no reason to take prophylactic antibiotics and this has been known for many years. I am not certain if there is something else going on here that the dentist insists, but otherswise antibiotics for cleaning teeth are usually not indicated.
Q. Can MVPS/D cause sudden death?
A. I am not aware of any data showing an increased incidence of sudden death in patients who have MVP and dysautonomia. I do not think I would spend time worrying about somethng happening that is not something that is known to occur.
Q Should I avoid alcohol at parties or is a glass or two of wine all right?
A. In most cases a glass or two of wine will not cause any particular change in your symptoms. You must remember, however, any form of alcohol, whether it is wine, beer, cocktail, etc., still involves an intake of sugar. Also the alcohol is a diuretic which will drop blood volume. Actually alcohol intake during warm summer months tends to cause more problems than it does in the winter months because of its added diuretic affect to what is already hot, humid wheather. As with anything you should certaily use caution, and if you notice it aggravates your symptoms you should limit your intake.
Q. My headaches are much worse just prior to my menstrul period. Is there anything that I can do to prevent them?
A. Many MVPS patients report that hormones tend to trigger their headaches. There is no absolute way to prevent this, but you might try a couple of things that have worked for some patients. First, avoid those chocolate cravings that are so comomon during that time of the month. Next be sure and get your usual exercise even if your energy levels seem low, and don't forget your fluids!
Q. Can MVPS patients use weight machines?
A. Usually we do not recommend upper-body weight training for patients with MVPS. However, patients who perform regular cardiovascular or aerobic exercise five times a week for thirty minutes or longer may try upper-body weight training using light weights. Lighter weight with more repetitions is better than heavier weight and fewer repetitions. There is no problem with patients doing upper-body handheld weight training during aerobics if this does not induce MVPS symptoms.
Q. Why does laying on your left side cause you to have more palpitations and pounding heart?
A. Palpitations , pounding heartbeat and increased cardiac awareness is quite common when you lie down and, in particular, on your left side. This is due to a positional shift in blood flow between different parts of your body and, in particular, the heart, which makes it start doing this. It is not anything to be concerned about, but it is noticeable in some patients and simply changing positions usually stops it.
Q.I suffer from pretty bad chest pain. I have had all the tests and have gone to the ER many times. If this pain is not coming from my heart, where is it coming from? (I do have MVPS/D.)
A. There are a multitude of causes of chest pain. With the MVP/dysautonomia patient, it is a very frequent symptom. You generally try to rule out any cardiac reason for it, and quite often it is due to other causes, such as gastrointestinal problems or perhaps even chest wall pain. The patient with dysautonomia is more likely to notice muscular types of chest pain. Also, reflux problems with the GI tract are also quite common with patients. This is a problem because there is nothing in particular that causes the chest pain, and it can be one of many different causes. That is why it is so complicated treating a patient with dysautonomia.
Q. The exercise I do four times a week is pretty intense. My instuctor likes me to drink Gatorade because it has electrolytes. I really don't like the taste. What else can I drink that contains electrolytes?
A. There are a lot of different sports drinks you can take that are more tasteful. Gatorade is only one of those. You need to read the label and be sure it has an adequate amount of sodium present, or you can simply make your own using one of the flavored drinks and simply add soduim to it. This is particularly important in the summer months when you need electrolytes to maintain blood pressure.
Q. Do I need to take vitamins? Will they help my MVP?
A. No, unless you are malnourished, dieting, or have another medical condiiton that requires vitamin supplementation, there is no data to indicate that vitamins are helpful in the treatment of MVPS. There is however no contraindication to using multipurpose vitamins if you need them.
Q. Will pregnancy hurt my MVPS?
A. No, in fact, our patients almost universally report that they feel much better during their pregnancy. We think this is due to an increase in blood voluume secondary to hormonal changes brought about by pregnancy.
Q. I had a panic attack last week at my dentisti's office after I received a shot of Novocaine. Could my MVPS have anything to do with this?
A. Yes, your dentist may have given you an injection of Novocaine with epinephrine (adrenalin). The adrenalin is useful for constricting blood vessles but is contrindicated in patients with MVPS because they are extremely sensitive to adrenalin and may precipitate panic attacks as well as irregular heart rhythm, rapid heart beat, and chest pain. Inform your dentist that you have MVP and make sure that he uses a local anesthetic without adrenalin.
Q. My pediatrician says that my child has a heart murmur. Does this mean that he has Mitral Valve Prolapse?
A. This is an excellent question. Most children have heart murmurs during childhood. The murmurs generally are benign and of no consequence. If a murmur persists past about age 10 or 12 it should be evaluated with an examination by a pediatric cardiologist using an echocardiogram and an EKG. Children generally do not show signs or symptoms of MVPS until they reach early teenage years. However, we are seeing this happening earlier. The incidence of MVPS in children younger than age 14 is generally not known.
Q.My doctor hears a click. What does that mean?
A. A click is a noise that your physician hears with a stethoscope if you have Mitral Valve Prolapse. The click is caused by the backward motion or snapping motion of the Mitral Valve during the period of time when the heart contracts. This is not to be confused with a murmur which is due to a leakage of blood across the valve. Most patients with MVP have a click, but no murmur. Sometimes the click is quite difficult to hear unless the physician listens to the patient in a lying, seated an standing position. The click tends to become much louder in the upright or standing position.
Q. Salt is supposed to contribute to high blood pressure. Why have I been told to add more salt to my diet?
A.Patients with Mitral Valve Prolapse have a condition known as hypovolemia. Hypovolema means that the amount of fluid circulating through the blood vessels of the body is less than normal. Mitral Valve Prolapse patients do not regulate their blood volume appropriately. Because of this we strongly recommend increasing fluid intake to compensate for this. Along with an increased amount of fluid intake, an adequate sodium intake from salt is also necessary. The added salt maintains an adequate fluid volume to prevent the hypovolemia as well as maintaining a normal blood pressure. This recommendation applies only to patients with MVPS. People who have high blood pressure or congestive heart failure should certainly follow their physician's advice. Rarely a patient with MVPS will also have high blood pressure rather than low. In this case the patient should consult with his or her physician before increasing sodium intake.
Q. I have been told not to participate in upper body exercises. Is it okay for me to play tennis?
A. Upper body exercise, particularly isometric exercise such as weight lifting, nautilus machines etc...tend to increase the symptoms in patients with Mitral Valve Prolapse Syndrome. Tennis is primarily an aerobic activity which is recommended for patients with MVPS. Although tennis involves some upper extremity movement it is still primarily aerobic and is an excellent way of exercising if you have MVPS. Of course other types of exercise such as aerobic dancing or jazzercise, zumba, walking, jogging and swimming are all alternative forms of aerobic exercises. Remember, however, to be sure that you have adequate fluid intake any time you exercise.
Q. Do you suggest taking a cardioselective beta-blocker for people with a lot of the cardiovascular symptoms from MVPS/D?
A. At times we would suggest a cardioselective beta-blocker, but at other times we found that a nonselective beta-blocker, such as Nadolol is extremely effective in preventing the migraines. Again, the beta-blocker should be chosen based on the clinical picture of the patient, along with appropriate testing.
We generally use one of about five or six beta-blockers depending on the choice.
Q. I have osteoporosis, I have been doing weight lifting every day and walking on a treadmill. I "upped" my workout a few weeks ago including heavier weights. I am experiencing PVCs. Why does adding more weight cause an upsurge in palpitations?
I am well hydrated. I am not on any medication.
A. It is not unusual to see isometric exercise such as you are describing increasing arrhythmias in patients with MVPS/D. We recommend doing primarily aerobic exercise, such as the treadmill and limit the isometic portion of your exercise to less than 50 percent of the total time. If you start experiencing palpitations, PVCs, etc., I would simply decrease the weight and intensity of the isometric exercise. In general, upper body exercise will cause more of the arrhythmia than lower body exercise would.
Q.Does an MVPS/D patient have a compromised immune system? A. Patients who have MVPS/dysautonomia may well have a compromised immune system in some cases. The prolonged stress hormone production that patients may have with dysautonomia can supress the immune system. We also see patients quite frequently who have compromised immunoglobulins. They may have low levels of either igG, igA, or igM* They generally respond to immunoglobulin infusions. the chronic stress associaed with dysautonomia probably plays a great role in compromising the immune system. *igG, igA, and igM are antibodies made by the body's immune system in response to bacteria.
Q. I have been having problems with my memory, forgetting things and not thinking clearly all the time. My doctor ran a CAT scan and MRI of my head, which was normal. He wanted me to ask you if this could be what happens sometimes if the autonomic system is off.
A. Our patients do quite frequently have problems with memory, concentration and focusing, and at times are easily distracted. In some cases this may represent ADD-type problems, which would be treated appropriately. In some cases the dysautonomia itself increases sensory input to a degree where memory and focusing can be affected. It is certainly responsible to evaluate for those other problems, but it is not at all unusual to see this, and it generally responds to the usual treatment to for their dysautonomia.
Q.I was wondering if the first medication you try on an MVPS/D patient suffering from a lot of PVCs and anxiety is a beta-blocker? A. The patient we see, after a full evaluation, usually will have more than just one medication to start with. We have found that it does not work very well just to partially treat the symptoms without treating all of the causes that are causing those symptoms. In many cases a beta-blocker is one of the medications, but we may also use and SSRI, or perhaps clonazepam in some of the patients. This all depends on the evaluation and what appears to be proper treatment for that particular patient.
Q. I am starting menopause, and my doctor has suggested progesterone for heavy bleeding and extremely sensitive breasts. Is progesterone, either cream or oral, okay for women with MVPS/D?
A. Patients with dysautonomia and mitral valve prolapse commonly have hormone imbalances and problems. It is important to see a physician who is very knowledgeable in adjusting hormones. Progesterone, in either cream or oral form, is certainly acceptable in the proper circumstances.
Q. Since I got older my very low blood pressure, 90/58, has gone up to 120/70. I must say that I feel better than I used to. I have less fatigue, dizziness, and fewer palpitations. Is this common in MVPS patients?
A. As patients with dysautonomia and mitral valve prolapse get older their symptoms definitely change. The marked fluctuations in blood volume probably also improve as well. It is not at all unusual to see more normal blood pressure as patients get older, particularly into their 40's and 50's. This would lead one to bellive that these symptoms such as some of the fatigue, the dizziness, and the orthostatic changes would also improve.
Q. I have been to three cardiologists. I'm beginning to belive that they are the worst doctors to see, maybe because they usually deal with life-or-death situations. None of them recognize MVPS/D. Do you have any suggestions as to what kind of doctor one should seek out?
A. It is important to find a physician who is knowledgeable about dysautonomia. The patient with prolapse who is developing symptoms has a disorder of the autonomic nervous system. In many cases a competent internist, family doctor, general practictioner, or gynecologist can diagnose and treat these problems. It is quite helpful to ask some friends who also have dysautonomia and mitral valve prolapse what doctor they go to, who they feel has been able to help them.
Q. Is there anything other than medications that will help keep heart rate down?
A. In general, regular aerobic exercise will help to keep heart rate down. This is due to conditioning and training. However, in patients who have mitral valve prolapse/dysautonomia this is not always true. If the patient is very aware of an increased heart rate and a forceful heartbeat, in general it will take medication to control the heart rate. Medications may include either beta-blockers or calcium channel blockers. Often a combination of a beta-blocker plus regular exercise will eventually lead to a more normal heart rate, which can then lead to taking medication only on an as-needed basis.
Q. Are medications for thyroid that doctors prescribe such as Armour thyroid and/or T-3 therapy okay for an MVPS/D patient?
A. The thyroid medications are definitely okay for MVPS/D patients to take. There is actually an increased incidence of hypothyroidism, or low thyroid function in patients who have MVPS/D. This is caused by an autoimmune disorder called thyroiditis. It is very important for these patients to have thyroid function checked every 12 to 24 months, as thyroiditis can occur and lead to a decrease in metabolism over a period of time. The medications can then be carefully regulated by the physician. Symptoms of low thyroid function would include fatigue, hair loss, weight gain, etc. These symptoms, of course, also occur in patients who do not have low thyroid. It is important to have this checked at periodic intervals by your physician.
Q. Can thousands of daily untreated PVCs harm one's heart?
A. Patients who have PVCs may well have thousands of them daily. The average number of heartbeats per day is around 100,000 or so. Certainly several thousand of those may be PVCs. It will not harm the heart per se, although you may experience symptoms of an irregular heartbeat. Of course, if this develops into a more dangerous type of rhythm problem, that would be a different situation.
Q. I always have a fast heartbeat. Even the slightest movement can cause me to have tachycardia. Will this eventually wear my heart out?
A. This will not damage or "wear out" your heart. It is uncomfortable and very unpleasant to have this occurring. This is generally due to increased adrenaline from the dysautonomia. A beta-blocker or similar type of medication should control this and help the symptoms. You probably would be experiencing a lot of fatigue unless this was treated with a beta-blocker.
Q. I have come across articles by nutritionists and natural health "experts" who say MVP is caused from over-calcification of the heart valves due to poor diet and from taking calcium supplements. Any comment?
A. Mitral Valve Prolapse is not caused by calcification of the heart valves and certainly diet has nothing to do with it. There is no data that confirms this.
Q. Can beta-blockers make the symptoms of cold hands and feet worse?
A. Beta-blockers can, in some cases, worsen the condition of cold hands and feet. In general, this is due to low blood volume and constriction of blood vessels in hands and feet from the dysautonomia itself. Some beta-blockers tend to cause more constriction in the hands and feet, which makes this much more noticeable. The best treatment, however, is increasing fluid intake and exercising regularly. This increases blood flow and quite often alleviates the problem. There are also some patients who have this symptom due to a disorder called Raynaud's, which is an autoimmune disorder that affects peripheral blood vessels, causing cold hands and feet.
Q. A year ago I tried taking a beta-blocker, but my blood pressure dropped so low that I felt I would pass out when standing. Also, changing positions from sitting to standing, bending over, and getting out of bed, caused severe lightheadedness. I would like to try a beta-blocker again. Are there any that cause less of a blood pressure drop than others?
A. The type of beta-blocker chosen is, of course, important; however, making sure that you have adequate fluid intake is more important. So too is finding out if low blood volume is contributing to the blood pressure drop. These symptoms are very common in patients with MVPS, whether they are on a beta-blocker or not. In general, lower doses, of course, would prevent having more of a blood pressure drop. In many cases the blood pressure is actually more normal when a beta-blocker is given. If this continues to be a problem, I would definitely choose one of the very mild beta-blockers, such as a 5 mgs. of betaxolol. You could also add Florinef in the morning to stabilize blood pressure, so that an adequate dose of beta-blocker can be given.
Q. Is Wolff-Parkinson White Syndrome in any way related to MVPS?
A. Wolff-Parkinson White Syndrome is an abnormality seen on an EKG where the heartbeat takes a shortcut through the heart and occurs earlier than it should. This, in some cases, leads to bouts of tachycardia. It does not seem to be related as far as its frequency of occurrence.
Q. I notice a difference in my heart rate when I first get out of bed in the morning. I've been trying to get up slowly, but it seems to take about 20 minutes. Are there any suggestions you can give me? I also notice a rapid heartbeat which changes when I change position, such as when I am lying down at night, and then I get up to go to the bathroom. Is this normal with MVP? I was on Tenormin for years but recently have come off of it with my doctor's okay. I'm trying to follow your advice by exercising five days per week and watching my diet, but sometimes I get so frustrated when my symptoms act up.
A. What you're describing is the typical changes seen in patients with MVPS due to low blood volume. As you stand up and change position, blood tends to pool in the lower extremities, and the heart has to pump harder and faster to compensate for this. The typical patient with MVPS has a blood volume lower than it should be. To solve your problem, you should increase your fluid intake with our recommendation of one ounce of fluid per degree of temperature outside, for a minimum of 64 ounces per day. As warm weather approaches you should be drinking 10 to 12 glasses of fluid a day. In addition, stopping the Tenormin has allowed the increased adrenaline that occurs with patients with MVPS to take hold, and you're experiencing the rapid heart rate from that also. Our suggestion would be to continue your exercise, increase your fluid intake, and consider going back on at least a small dose of Tenormin, even if it's every other day.
Q. I have been taking Zoloft (25 mgs. twice a day) for three years to help combat my symptoms. Is it possible to stay on an antidepressant indefinitely to help control the symptoms of dysautonomia?
A. You certainly may take any of the serotonin medications indefinitely to control symptoms of dysautonomia. In some cases patients do not need as much of the medication in the summer months, as the body produces more serotonin in the summer months compared to the winter months. Again, the need for medicine tends to change. We have also seen in our practice that at times the patient seems to start producing more serotonin on their own, and the need for medication drops to the point where they can either take it perhaps intermittently or get off the medicine entirely. Each case is somewhat different. I am not aware of any long-term effects from these medications.
Q. I am on a softball team. Is this considered aerobic exercise?
A. No, aerobic exercise is continuous exercise that utilizes large muscle groups in the body for a period of time of at least 20 minutes with substantial elevation of the heart rate. Since most of the time spent during a softball game is either standing on a base or sitting on a bench, your body is not is an aerobic state at all. Be aware that extreme upper body motion (such as swinging a bat or throwing a ball) may induce chest wall soreness.
Q. I frequently have sharp, stabbing pain in the left side of my chest. I am afraid it is my heart, but my physician assures me that it is costochondritis. What is costochondritis, and is it due to my MVP?
A. Costochondritis is an inflammation of the ribs in the anterior chest wall. It may follow trauma, be associated with arthritic-type disorders, and is a frequent cause of chest pain in MVP. It is usually described as a sharp, stabbing or sticking type of pain that may radiate widely throughout the chest. Palpation over the area of pain often exhibits marked tenderness. Although aggravating, it is not serious and usually responds well to the use of aspirin or ibuprofen (Advil).
Q. My son has been diagnosed with ADD. His doctors want to put him on Ritalin. For a long time now I have thought that he inherited my MVPS. He has many of the symptoms I have. If he does have MVPS would Ritalin be a safe drug for him to take?
A.Your question does not state the age of your son, but I assume that he is a teenager or, perhaps, younger. We certainly have seen quite a few patients diagnosed with ADD and ADHD who also have MVP syndrome/dysautonomia. In our experience the medications currently used for this disorder have not been a major problem in increasing symptoms of MVPS/D. If he, indeed, does have this condition, I would see no problem with at least trying the Ritalin. If he still has other symptoms perhaps not due to ADD, then consideration should be given to perhaps MVPS/D causing some of these symptoms.
Q. I have recently been feeling tired and run down, so my doctor took blood tests and said my cortisol levels were the highest he had ever seen, 36.6, and my thyroid was 0.84. He put me on Synthroid, 0.24 mgs. I took one pill and started feeling panicky. My doctor said not to take any more and is sending me to an endocrinologist. I should tell you that I am already on Celexa, 12.5 mgs. and 1/2 tablet of Buspar every day. My questions are: Is it common for people with MVPS to have very high cortisol levels, to be sensitive to Synthroid, and to have thyroid problems?
A. There is definitely an increased incidence of thyroid dysfunction in patients who have mitral valve prolapse syndrome/dysautonomia. We see an incidence as high as perhaps 20 percent of our patients who have had what appears to be thyrioditis, which leaves them with an underactive thyroid gland. This is easily tested by a thyroid profile and, in particular, an ultra-sensitive TSH test. I am not aware of any studies that show an increased incidence of high cortisol in patients with MVPS. We occasionally do check these levels, but rarely find them to be elevated. Certainly the thyroid abnormality is more common. An evaluation by an endocrinologist would be appropriate in this situation.
Q. I had a stress test, and my heart rate was 220 after 12 minutes on the treadmill. A cardiologist told me this was normal for an active, healthy 25 year old. Do you agree with this? I do wear a heart monitor when I work out in the gym, and my heart rate does get near 220.
A. A heart rate of 220 bpm after exercise would be considered excessive. We quite frequently do see heart rates in the 180 to 200 range, particularly in younger persons during exercise. In many cases they do become symptomatic. Quite often this is due to a form of dysautonomia called postural orthostatic tachycardia syndrome (POTS). In some cases the patient has excessive stimulation from adrenaline. Many patients are very symptomatic in this situation and tend to eventually become fatigued. Quite often it is easy to simply add a beta-blocker to control the heart rate; the patient becomes asymptomatic and, thus, the fatigue improves.
Q. I am a 60-year-old female who has smoked cigarettes for 40 years. I tried unsuccessfully to quit numerous times. My question is: Can a person with mild MVP, also diagnosed with depression, anxiety, ADD, and OCD, who is afraid to take strong medicine, use Zyban or Wellbutrin, with or without the nicotine patch?
A. We indeed do use Zyban and Wellbutrin, which chemically are the exact same medications, in patients who either wish to quit smoking or lose weight. This medicine is very effective in controlling the craving of the brain for nicotine, carbohydrates, etc. We do not use the nicotine patch, as you are simply feeding more nicotine into the body at a time when you are trying to withdraw from it. One of the most important things is to continue the medication for a period of two to three months after you have quit smoking. Whether a patient should do this who also had ADD or OCD should be discussed with your physician before starting it, however.
Q.In the past I have been asked many times if mitral valve prolapse is the same thing as a leaky valve or mitral regurgitation? Lyn Frederickson, R.N., MSN
A. A leaky valve, or regurgitation, implies a backflow of blood into the heart and is not the same as mitral valve prolapse. MVP patients, however often have a very small, insignificant murmur that represents a very small backflow. Mitral regurgitation can result from other conditions, such as cononary heart disease and even rheumatic heart disease. These conditions are quite different from MVP and have a much different significance.