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Heart & Cardiology/mitral valve prolapse - trivial regurgitation

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Question
My 20 year old daughter has just had an echocardiogram and has been told that she has mild leaflet thickening, mild MVP involving posterior leaflet, trivial regurgitation. I have been reading the Mayo and Hopkins sites and they say that generally MPV is asymptomatic, however my daughter has been complaining for years of general fatigue, panic attacks, shortness of breath, dizziness, chest pain and arrhythmia. She recently went to an allergist who said that she had impaired lung function. She also has low to normal blood pressure. Perhaps a diagnosis of costochondritis when she was 16 was incorrect?
When we go to visit the GP, I'd like to make sure we ask the right questions.
Should she get a stress test?
Should she get a second echo?
Why does she have symptoms like this if she only has trivial regurgitation. I'm quite worried now that we have a "label" for these issues.
Thank you so much for your help.

Answer
Hello Teresa,

Her prolapse and mild regurgitation are not and will not ever cause any trouble.  Her breathlessness and fatigue may be coming from her lung trouble.  Chest pain in a young person is usually cramping of muscles in the chest wall.  If pushing on the painful area modifies the pain (makes it better or worse), or if the pain is relieved by bending the body away from the painful area, that proves the pain is from chest  wall.  Even if these maneuvers donít affect the pain, itís still probably chest wall.  Pain caused by narrowing of the coronary arteries that supply blood to the heart is extremely rare below age 40. Chest wall pain is no threat to life or health, just a big nuisance.  Safest management is just to ignore the pain, though Tylenol, aspirin or ibuprofren usually help.

She doesn't need a stress test or another echo.

Please write back if this note doesnít answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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