Hi there -
MVP is one of the most common "abnormal" findings, with estimates of up to 15 per cent of the population having some degree of it. While there are two kinds, the far more common type is often considered a "variant of normal;" the other more rare sort is a degenerative myxotomous disease that can be progressive and sometimes requires surgical intervention. This latter type is usually easily visualized on
echocardiogram as it generally looks much different from the "normal" type.
As for the variations in your two
echo reports: both are within normal limits. It's important to understand that it would be unusual for two different exams on two different days to yield exactly the same results.
MVP is especially variable from day to day, and in some patients it cannot be seen at all on some days, while is fairly clear on others. While the
echocardiogram is an invaluable tool, it only "sees" what is there on a given day, and to some degree is influenced also by the technician's style. Given these vagaries, your two reports are very consistent and very normal with the exception of "moderate" mitral regurge, which is greater than "trace", which almost everyone has at some times. For this reason it should be followed, even though the likelihood of it progressing to a problematic degree is very slight.
As for the symptoms you describe, they are all commonly associated with
MVP syndrome, a syndrome which only occurs in a minority of the very many people who are known to have
MVP. This, of course, is still a relatively rather large number of people. The sharp, stabbing pains,
anxiety, perceived difficulty breathing (yet exercise is generally well-tolerated), and sometimes frequent premature heartbeats ('flutter" sensations or sense of a "skipped" beat), unwarranted fatigue (again, with exercise generally well-tolerated),
panic attacks, and even a faster-than-average resting heart rate, are all classic for both
anxious patients and patients with
MVP syndrome. It is unclear what the connection is between the "redundant" leaflet tissue and the symptoms, but it's common enough to be considered classic.
The
echo reports, side by side, do not indicate that your heart has enlarged, only that there are differences between the two exams, but that both are within normal limits. Again, this is the rule, and to have an exam exactly replicate a previous one would only happen in an android with a mechanical heart or if someone had accidentally pulled up the previous report by accident.
The best number in the bunch is yuor ejection fraction, which is preferred to be higher rather than lower, although the normal range is between 50 and 70+. Yours was already very good and the second time was even a little better. In both cases it was excellent. It is the most crucial number of them all. Your resting heart rate is also normal.
Your prolapse may have increased slightly, or it may have simply been more prominent on the day of the second exam than the first one. Because of this you will likely have the test done again, and if there is an increase in any of the prolapse or regurge numbers and you also have symptoms which might relate to that, then you'd be evaluated further. However, this is very unlikely, since there is no mention of myxotomous disease. The next exam could as easily show an "improvement." This is the nature of these things generally.
The situation, as described in your two reports, would not cause
cardiomyopathy, and there is no reason to assume that might happen in the future. Generally a seriously failing mitral valve with myxotomous disease is most likely to cause a weakening and dilated
cardiomyopathy of the left ventricle, but so far you have nothing to suggest this is taking place or that it will. Your exams, again, are very normal with that one exception of "moderate" regurge, which could stay that way or could be less (or missing) during the next exam.
Oh! Also, no,
MVP cannot be caused by heavy lifting or exertion. The
MVP syndrome symptoms, however, are sometimes triggered initially by stress, at which time the patient discovers he or she has
MVP.
MVP is almost always genetic in origin, and is rarely acquired. One way it can be acquired is by use/abuse of amphetemines, although this is difficult to prove because it is such a common condition anyway.
You're in very good company. There are millions of people out there with similar
MVP findings. Some have more or less severe symptoms associated with it, and the majority are completely unaware of it.
I hope this helps ease your your concerns about this very common, sometimes annoying, very rarely serious problem. Good luck to you, and please do follow up with us as needed.
