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What Causes Chest Pain In A Patient With Mitral Valve Prolapse And Anxiety?

Posted on Mon, 11 Jun 2018

Question: I am 62 year old white male .. 5'11" / 185 lbs ... exercise regularly ... have been diagnosed many years ago with mitral valve prolapse. I also have anxiety / depression. I have been taking 50-100mg daily of sentraline and buspirone as needed and had been taking quetiapine 25-50 mg at bedtime for sleep .. December is a busy month and stressful (insurance sales) ... I had not experienced many symptoms of MVP for sometime. I began feeling chest pain a few weeks ago and is now more significant. in the area where I have experienced mitral value pain before. I looked up side effects of quetiapine and it is not supposed to be taken if you have heart muscle weakness. I stopped taking a few days ago and am still experiencing pain .. could the use of this medication caused damage to my mitral valve ?

Answered by Dr. Bhanu Partap (1 hour later)

Brief Answer:
Kindly refer to the detailed answer below.

Detailed Answer:
Hi There

After going through the medical details provided by you I understand your concern and would like to tell you that kind of chest pain you are describing can be because of MVP progression if associated with fatigue, breathlessness or palpitations. Atypical chest pain can be because of anxiety disorder or a side effect of Sertraline.

Mitral valve prolapse occurs due to degeneration of mitral valve leaflets or fibroelastic deficiency and there is no side effect of Quetiapine in MVP . As you have been diagnosed with MVP few years back, you should get some cardiac checkup done to evaluate the progression of MVP now for a proper treatment.

If you are experiencing any breathlessness or palpitations with chest pain then do mild aerobic exercise and avoid alcohol, caffeine and cigarettes.

Kindly get an ECG and Echocardiography done and personally consult with a Cardiologist for physical and diagnostic evaluation .

Hope to have been helpful.

Kind Regards
Dr Bhanu Partap

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Bhanu Partap (19 hours later)

thank you for your response .. over the years I can remember times of aching and discomfort in my chest .. generally after times of a prolonged period of stress / anxiety .. I have always struggled with anxiety / obsessive worry ... I have countered by exercising regularly .. I can be prone to excessive alcohol consumption a few days a week ( 4-6 drinks) ... November-December have become my busiest months as my largest accounts renew then ... I began feeling some symptoms of palpitations / some sharp pains I've become accustomed to under stress .. I recently drove from ohio to florida for an extended vacation .. on the drive down the aching became "deeper" and I felt a kind of "sick feeling" in the upper left part of my chest .. I experienced this type of feeling several years ago but have not for sometime and not to this extent .. my blood chemistry is always vey good .. and blood pressure is nearly always good (high for me is 138/80) for years I was mainly 110/70 and have noticed this somewhat higher reading last few times at the doctor ... (my last echo was 2 years ago and was told very mild regurgitation)I am very surprised to be experiencing this level of pain ... it does subside with rest .. I've taken Inderal on an as needed basis for many years .. I've begun taking more often (20mg 1-2 daily) which has seemed to help and Xanax has seemed to help relieve the discomfort .. I guess my main question at this time is .. could the valve have gotten much worse very quickly or could I just be exhausted from stress / anxiety and will return to "normal" after rest (I've been in florida 6 days and getting rest) ... sorry for the long question .. I will plan to get a physical evaluaton soon .. i was intending to be in florida for several more weeks and was wondering if the physical could likely wait until my return ?

Answered by Dr. Bhanu Partap (4 hours later)

Brief Answer:
Hello Again

Detailed Answer:
Thanks for the detailed feedback.

What i would like to suggest you is as such there is no worry for now and as you came out for a vacation out of your stress zone probably things will improve in few days.

But if it doesn't then it become important to see your cardiologist as early possible for detailed evaluation.

For every patient the rate of progression of the severity of mitral valve prolapse varies so its difficult to comment whether or not it has worsened in your case.

So just relax and enjoy your time and wait and watch.

Kind Regards
Dr Bhanu Partap

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Bhanu Partap (12 hours later)

ok thank you

Answered by Dr. Bhanu Partap (0 minute later)

Brief Answer:
Hello again

Detailed Answer:
It’s been a pleasure answering your query. In future if you want an opinion from me then kindly write my name in your question.

I wish you all good health.

Kind Regards
Dr Bhanu Partap

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Prasad