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What Causes Heart Palpitations And Breathlessness When Diagnosed With Mitral Valve Regurgitation?

Posted on Wed, 23 Dec 2015

Question: Hi , my symptoms are ...every night during the early hours I am awakened with my heart pounding or undulating, very strong, at the same time I am on fire , not sweating ....I am out of breath and feel dreadful.......I get out of bed to cool down and compose myself !!

My blood presure has always been very high early hours and in the morning , and not too bad during the day.........However in the last two months there has been some changes....where my high blood presure dropped to very low and my hear beat very fast during the night , and then through out the day , so I had to stop taking my Doxazosin from 3mg / 2mg/1mg ..and finally none , over a few weeks ! Now my blood presure is on the rise and have been advised to start on 1mg per day for a month . Personally I am not too worried about my blood presure ...I would just like to get a good nights sleep ...I am constantly desperatly tired ..no energy ...always out of breath...and any kind of exertion wears me out ... I had a Scan on my heart a few months ago and it showed up a mild Mitral Reguratation .....I cant help but wonder if this could be the cause of my night time problems ??

Answered by Dr. Benard Shehu (2 hours later)

Brief Answer:
Following advice...

Detailed Answer:
Hi and thank you for asking!
I read your query and understood your concerns.

Your symptoms shouldn't be related to the mild mitral regurgitation. Mild mitral regurgitation is asymptomatic and it's only found out during cardiac echo. As long as heart function was normal (on cardiac echo) than your symptoms aren't related to heart issues. Your symptoms may be related to Doxazocin side effects and should be gone away after a couple of weeks of stopping the treatment..

However, If you were my patient I would recommend to do a full cardiac evaluation with the following exams to definitely exclude any cardiac problems:
- ECG
- Cardiac ECHO
- Stress test
- Chest x-ray
- Holter monitoring
- Abdominal ultrasound
- Upper endoscopy

Moreover, acid reflux (GERD) should be excluded because GERD may mimic most of your symptoms. This is why i recommended to do the last two examinations.

Since Doxazocin has also as a side effects triggering or worsening (if you have suffered from anxiety in the past) of anxiety and depression, you should contact a psychologist. The psychologist is important to exclude any psychological component to your symptoms.

Hope this will be of help!
Wish you health!
Dr. Shehu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (3 days later)

\Good morning , ....Thank you for your advice ....it is good to hear that my " Mitral Valve Reguratation " is not related to my symptoms . Do I take it that my symptoms could be related to Gerd or Sliding Hiatus hernia ??

I do not think that my symptoms can be related to Doxazosin , as I have only been on them for a few month's , and I need them to control my BP.......Whereas I have had my night time "trauma's" for over 2 years , and getting worse ! Also i have been diagnosed with a sliding Hiatus Hernia 18 months ago , been on Pantaprozole since then , along with Dompreridone , untill it was taken off the market earlier this year .

Best regards ..........XXXX .

Answered by Dr. Benard Shehu (8 hours later)

Brief Answer:
Following advice.

Detailed Answer:
Hi back again,

You are right, your symptoms aren't related to mitral valve regurgitation but most probably it's related to GERD and hiatal hernia.

Moreover, I would like to suggest the following life style and dietary changes to relieve your symptoms:
- Eat a healthy diet reach in fresh vegetables and fruits and white meat, poor in diary products.
- Quit smoking.
- Avoid caffeine, carbonated and energy drinks.
- Reduce alcohol to less than one drink perday.
- Avoid consuming beens, cabbage, lettuce etc.
- Use antacids (malox) together with pantaprosol.

Hope this will be of help!
Wish you health!
Dr. Shehu
p.s: If you are satisfied with my answer, please close this query and rate it to maximum.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (15 hours later)

What do you think I should do about my ongoing problems .....As I have been on medication for nearly two years , and know all about lifestyle changes ! None of which has helped me in any way , My symptoms have become steadily worse , and are unbearable ?? Any suggestions ??

Answered by Dr. Benard Shehu (13 hours later)

Brief Answer:
Following answer to your query.

Detailed Answer:
Hi back,

First of all it's essential to know the severity of hiatal hernia. If it's larger than 5cm (and since the medical treatment has been inefficient to relieve your symptoms) you should discuss with a surgeon about surgical intervention.

Hope this will be of help!
Wish you health!
Dr. Shehu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (10 hours later)

Good morning , and thank you for answer ...Can you tell me what kind of Surgeon I should be
looking for ? Can you recommend one , I live in Bolton Lancs ,?

Answered by Dr. Benard Shehu (9 hours later)

Brief Answer:
Following advice...

Detailed Answer:
Hi back,

You should discuss with a General surgeon specialised on gastrointestinal surgery.

Unfortunately I leave in Europe and it's difficult to recommend a good surgeon in your area.

Hope this will be of help!
Wish you health!
Dr. Shehu

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar