Sunday, March 31, 2013

That's me...

"Mitral valve is one of the valves of the heart, whose function is to keep the blood flowing in one direction through the left side of the heart, and to prevent backflow of blood when the heart contracts. It's named for its shape, which resembles a tall bishop's hat called a miter. It's made up of two triangular-shaped fibrous membranes, thin but tough, which are attached to strong cords like parachute cords, in turn attached to muscles. When the heart contracts, the two leaves billow up to close off the opening between the upper atrium and the lower ventricle on the left side of the heart. "Prolapse" means that the two leaves are a little loose, a little floppy, so that the valve doesn't close as firmly as it might. It may close with a faint click, or may permit a tiny amount of blood to leak through, producing a heart murmur.
Though mitral valve prolapse was first identified as an anatomical abnormality of the heart, it's not simply a heart disease in the conventional sense. Cardiologists are beginning to look at this not as a single variation of heart anatomy, but as a whole spectrum of abnormalities, many benign and harmless, but some troubling. Curiously, most of the abnormalities seem related to an underlying instability of the autonomic nervous system. This is the part of our nervous system that regulates the internal, visceral functions of the body--such as blood pressure, heart rate, sweating, body temperature, gastrointestinal activity, and emptying of the urinary bladder.
People with mitral valve prolapse seem somehow to be wired differently. Their autonomic response can be much more volatile and unstable, as if set on hair-trigger, so that normal stresses and surprises set off an exaggerated response, flooding their systems with stress hormones called the catecholamines. In fact, there may not be a specific stressor--autonomic fluxes may occur unpredictably like internal weather changes. In some ways this could be defined as a catecholamine disorder. The principal catecholamines are epinephrine and adrenaline. People with mitral valve prolapse are intermittently and unpredictably awash in their own catecholamines. This leaves them alternately innervated and exhausted--"wired but tired" is a common feeling.
If the sympathetic nervous system of a person with MVP is aroused, they can suddenly feel crushing chest pain, with heartbeat racing and pounding. They may begin to hyperventilate, feel short of breath, and break out into a cold sweat. Certain people with mitral valve prolapse sometimes experience this with no apparent warning or immediate threat. There can be sensations of chest pain, a feeling of doom or detachment, a fear of dying, or a desire to flee. If you don't know why this is happening, the symptoms themselves are scary, and the fear of the unknown can prompt an even greater release of stress hormones, driving you into the kind of meltdown of the autonomic nervous system that we call a panic attack. This is an intense, visceral, and scary experience, and the sensations can easily be confused with those of a heart attack. Emergency room physicians see a great number of people who come in believing that they are having a heart attack, when they are actually experiencing a panic attack. Once people experience this, they generally have a persistent fear of having another attack, which puts them on a "hair trigger," ready to respond to the slightest symptoms by releasing the very stress hormones that induce the panic attacks, thus escalating a new attack.
It may seem odd that all of these symptoms should be somehow related to a heart abnormality. In fact, it's not that the mitral valve abnormality causes these other symptoms, but it is a physical trait that is a marker of the underlying condition. The valve abnormality was spotted first, and is the name given to the syndrome, but we are now beginning to be able to identify the underlying problem that is manifested in other ways than the heart murmur. The good news is, once we've identified it for what it is, we can effectively manage the condition, and the symptoms.
What are the symptoms of mitral valve prolapse condition? Instability of the autonomic nervous system can cause or influence a dizzying variety of seemingly unrelated symptoms and conditions, affecting many different systems of the body. These include:
~ Migraine headaches ~ Dizzy, spacy feeling ~ Difficulty concentrating ~ Balance problems, vertigo ~ Insomnia, sleep disturbances ~ Hyperventilation; shortness of breath ~ Palpitations of the heart; skipped or irregular heart beat ~ Panic attacks, with pounding heart beat ~ Phantom chest pain with no apparent physiological cause ~ Hypersensitive startle reflex ~ Cold sweats ~ Cold hands and feet ~ Numbness or tingling in the fingers or toes ~ Bowel urgency, diarrhea, constipation ~ Sensitivity to drugs, including alcohol, caffeine, and medications (caffeine prevents the natural absorption of catecholamines, so that they linger in the body. Caffeine and theobromides in chocolate are related to medications used to treat asthma, which work by inhibiting the absorption of catecholamines.) People with mitral valve prolapse are especially sensitive to all kinds of drugs and medications.
Various systematic health problems and imbalances can act as triggers that set off or amplify the autonomic instability. These include:
~ Hypoglycemia ~ Adrenal instability, with hyperactivity followed by adrenal exhaustion ~ Hypothyroidism ~ Chemical sensitivities ~ Food reactions ~ Fluctuating sex hormones, especially estrogen, causing worsened symptoms of PMS and menopause ~ Magnesium deficiency"