Mitral Valve Prolapse
• Dysautonomia; Mitral Valve Prolapse Syndrome; MVP
Principal Proposed Natural Treatments:
Other Proposed Natural Treatments:
• 5-HTP (5-Hydroxytryptophan); Acetyl-L-carnitine; Acupuncture; Arginine; CoQ10; Creatine; Gamma-linolenic Acid; Hawthorn; Hops; Kava; L-carnitine; Lemon Balm; Lipoic Acid; Melatonin; Multivitamin/Multimineral Supplements; OPCs; Passionflower; Taurine; Valerian; Vitamin B1; Vitamin E
Mitral valve prolapse (MVP) affects about 2% of people in the United States.1 (Past estimates were higher due to errors in diagnosis.) As the name suggests, MVP involves prolapse of one of the valves of the heart, the mitral valve.
The mitral valve sits at the opening between the left atrium and left ventricle, and opens and closes so that blood flows only in one direction (atrium to ventricle). In MVP, the mitral valve fails to make a proper snug fit, and instead billows (prolapses) back into the atrium, making a sound that can be heard through a stethoscope.
MVP is generally benign. Sometimes, however, the mitral valve fits so poorly that a large amount of blood leaks back from the ventricle to the atrium. This is called “mitral regurgitation,” and it can be dangerous, eventually requiring surgery.
In the past, a set of symptoms called dysautonomia was thought to frequently occur in association with MVP. Dysautonomia involves malfunction of the autonomic nervous system (the part of the nervous system that is not under conscious control). MVP plus dysautonomia used to be called the “Mitral Valve Prolapse Syndrome.” Symptoms were said to include:
However, recent evidence indicates that symptoms of dysautonomia occur with no greater frequency in people with MVP than in people without MVP. In other words, there is probably no connection between the two conditions. People who were previously diagnosed with MVP Syndrome are now said to have two separate conditions: MVP plus symptoms of dysautonomia. The cause of these dysautonomic symptoms is not clear, but probably involves a response to stress.
Conventional treatment for MVP involves regular monitoring for mitral regurgitation, along with maintenance of normal weight and blood pressure to avoid excess strain on the valve. In addition, people with MVP are given antibiotics prior to surgical or dental procedures. Those procedures may release bacteria into the bloodstream and, in people with MVP, bacteria may stick to the valves and cause infection (a condition called endocarditis). Antibiotic treatment can prevent this.
People with MVP who also have symptoms of dysautonomia may be separately treated for those symptoms as well.
Principal Proposed Natural Treatments
Low levels of magnesium can cause some symptoms similar to dysautonomia. One study evaluated 141 people with MVP and dysautonomia and found that 60% of them had low levels of magnesium in the blood.2 This subgroup of people with low magnesium were then enrolled in a 10-week, double-blind, placebo-controlled crossover trial. (They received placebo or magnesium supplements for 5 weeks, and then were “crossed over” to the other group.) People receiving magnesium experienced a significant reduction in dysautonomic symptoms, such as chest pain, palpitations, anxiety, and shortness of breath.
Note that it is unlikely that these people suffered from magnesium deficiency. Magnesium deficiency is thought to be a rare condition. More likely, low magnesium levels are a consequence of some other factor that also causes dysautonomia symptoms. Regardless, magnesium supplementation could help treat such symptoms. However, more studies are necessary to validate this promising possibility.
For more information, including dosage and safety issues, see the full magnesium article.
Other Proposed Natural Treatments
Various herbs and supplements that are hypothesized to help the heart in miscellaneous ways (such as treating congestive heart failure or preventing coronary artery disease) are often recommended for MVP as well, on general principles. These include arginine, CoQ10, creatine, hawthorn, L-carnitine, OPCs, taurine, vitamin B1, and vitamin E. However, there is no scientific reason to believe that any of these natural treatments would help MVP.
A variety of other natural treatments are used to treat anxiety -related dysautonomia symptoms. These include the following:
A serious form of autonomic nervous system dysfunction can occur in people with diabetes. The supplements lipoic acid, acetyl-L-carnitine, and GLA (gamma-linolenic acid) have shown some promise for this condition, and for this reason have been recommended for the treatment of the dysautonomic symptoms noted above.
Herbs and Supplements to Use Only with Caution
Numerous herbs and supplements may interact adversely with drugs used to treat mitral valve prolapse. For more information on this potential risk, see the individual drug article in the drug interactions section of this database.
References [ + ]
1. Freed LA, Levy D, Levine RA, et al. Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med. 1999;341:1–7.
2. Lichodziejewska B, Klos J, Rezler J, et al. Clinical symptoms of mitral valve prolapse are related to hypomagnesemia and attenuated by magnesium supplementation. Am J Cardiol. 1997;79:768–772.
Last reviewed December 2015 by EBSCO CAM Review Board