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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Dr. Bob on August 19, 2003, at 23:44:11
In reply to mitral valve prolapse and anxiety/panic/depression, posted by mopey on August 19, 2003, at 22:17:16
> I've read that MVP can cause anxiety, panic and depression, but my doctor doesn't agree (of course it would make her redundant, I suppose...!).
>
> Has anyone here done research on this? Any of you have MVP, as I do?
>
> There's a lot of debate within the medical community, so I'm eager to hear your opinions.
>
> Thanks!
Posted by think2much on August 20, 2003, at 4:43:13
In reply to mitral valve prolapse and anxiety/depressi « mopey, posted by Dr. Bob on August 19, 2003, at 23:44:11
I've read in *many* different places that MVP can cause panic, anxiety and depression. I have read in one Medical Encyclopedia that up t0 50% of those with anxiety disorders have this complaint, though that figure seems pretty high to me. Your doc needs to go to the likes of WebMD to learn about these things! I think it could really help people to know that this is what sparks off their panic.
May I ask how your MVP was diagnosed? I was wondering whether I suffered from it, though I don't know what the test would be. I recently had an ECG though (arrhythmia problems in the family and the doc wanted me to try a trycyclic) and that came back clear.
Posted by Larry Hoover on August 20, 2003, at 6:37:02
In reply to mitral valve prolapse and anxiety/depressi « mopey, posted by Dr. Bob on August 19, 2003, at 23:44:11
> > I've read that MVP can cause anxiety, panic and depression, but my doctor doesn't agree (of course it would make her redundant, I suppose...!).
I wouldn't agree, either, that MVP causes all these psych symptoms.....I believe that they have the same cause. They are certainly very highly correlated. For example, a study in France showed that panic disorder has a 800% higher incidence in MVP than in the general population. And, in a study below, it was found that 80% of the study group with MVP had either panic disorder, major depression, or both.
Your doctor is keeping up with the literature. She's incompetent, not fearful of redundancy.
> > Has anyone here done research on this? Any of you have MVP, as I do?
Yes, and yes.
> > There's a lot of debate within the medical community, so I'm eager to hear your opinions.
> >
> > Thanks!Believe it or not, all of your symptoms may be caused by a magnesium deficiency state. There is no blood test to detect this, as only about 1% of your magnesium will be in the blood at any point in time, and that may be normal, while your body is starving for the mineral.
The only accepted test for magnesium deficiency is oral magnesium loading. Simply put, you take a bunch of magnesium, and if your symptoms start to disappear, then you had a magnesium deficiency.
The best treatment ever found for MVP is magnesium supplementation.
Magnesium deficiency causes anxiety.
Magnsium deficiency is a causative factor in depression.
Magnesium deficiency is a causative factor in panic disorder.
Here's some evidence...
Am J Med. 1990 Dec;89(6):757-60.
Comment in:
Am J Med. 1991 Jul;91(1):103.Major depression, panic disorder, and mitral valve prolapse in patients who complain of chest pain.
Carney RM, Freedland KE, Ludbrook PA, Saunders RD, Jaffe AS.
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
PURPOSE: Patients with chest pain but without angiographic evidence of significant atherosclerotic coronary artery disease (CAD) are often found to have other medical or psychiatric disorders, including mitral valve prolapse, panic disorder (PD), and major depressive disorder (MDD). The purpose of this study was to determine the degree of comorbidity between MDD/PD and mitral valve prolapse in a group of patients with non-CAD chest pain. PATIENTS AND METHODS: Patients referred for cardiac catheterization and coronary angiography for suspected CAD who were 70 years of age or younger and without other significant medical illnesses or cardiac complications were eligible for study. The first 100 patients who agreed to a psychiatric diagnostic interview were recruited. RESULTS: Forty-eight of the 100 patients were found to be without significant CAD. Forty-two percent of these patients, compared to 19% of the patients with significant CAD, were found to have either MDD, PD, or both. Eighty percent of the patients without CAD who had mitral valve prolapse also had either MDD or PD (p less than 0.006). CONCLUSIONS: The finding that mitral valve prolapse was significantly associated with MDD/PD has implications for the diagnosis and treatment of patients with non-CAD chest pain, and may explain why these patients complain of symptoms.
Magnesium 1986;5(3-4):165-74Magnesium deficiency in the pathogenesis of mitral valve prolapse.
Galland LD, Baker SM, McLellan RK.
Idiopathic mitral valve prolapse (MVP) is the commonest valvular disorder in industrialized nations. It is predominantly a familial condition, showing Mendelian dominance with delayed and variable penetrance. Although hyperkinesis and hypertrophy of the left ventricle have been described in MVP, its histopathology, somatic morphology and genetics support the leading theory that MVP results from a hereditary disorder of connective tissue. Latent tetany (LT) due to chronic Mg deficit (Mg-D) occurs in over 85% of MVP cases; MVP complicates 26% of LT. Mg-D can explain many clinical features of the MVP syndrome which are not easily explained by its genetics. Mg-D hinders the mechanism by which fibroblasts degrade defective collagen, increases circulating catecholamines, predisposes to cardiac arrhythmias, thromboembolic phenomena and dysregulation of the immune and autonomic nervous systems. Mg therapy provides relief of MVP symptoms.
Am J Cardiol. 1997 Mar 15;79(6):768-72.Comment in:
Am J Cardiol. 1997 Oct 1;80(7):976.
Clinical symptoms of mitral valve prolapse are related to hypomagnesemia and attenuated by magnesium supplementation.Lichodziejewska B, Klos J, Rezler J, Grudzka K, Dluzniewska M, Budaj A, Ceremuzynski L.
Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
Mitral valve prolapse syndrome (MVP) is a frequent disorder characterized by a number of complaints which lessen the quality of life. The pathogenesis of MVP symptoms has not been fully elucidated. Hyperadrenergic activity and magnesium deficiency have been suggested. This study was designed to verify the concept that heavily symptomatic MVP is accompanied by hypomagnesemia and to elucidate whether magnesium supplementation alleviates the symptoms and influences adrenergic activity. We assessed serum magnesium in 141 subjects with heavily symptomatic primary MVP and in 40 healthy controls. Decreased serum magnesium was found in 60% of patients and in 5% of controls (p <0.0001). Patients with low serum magnesium were subjected to magnesium or placebo supplementation in a double-blind, crossover fashion. Typical symptoms of MVP (n = 13), intensity of anxiety, and daily excretion of catecholamines were determined. After 5 weeks, the mean number of symptoms per patient decreased from 10.4 +/- 2.1 to 5.6 +/- 2.5 (p <0.0001), and a significant reduction in weakness, chest pain, dyspnea, palpitations, and anxiety was observed. Increased noradrenaline excretion before and after magnesium was seen in 63% and 17% of patients, respectively (p <0.01). Mean daily excretion of noradrenaline and adrenaline was significantly diminished after magnesium. It is concluded that many patients with heavily symptomatic MVP have low serum magnesium, and supplementation of this ion leads to improvement in most symptoms along with a decrease in catecholamine excretion.
I'm sorry for the brief reply. I've got a busy day today. Ask all the question you want to. I'll get back to them later.Lar
Posted by Larry Hoover on August 20, 2003, at 6:40:56
In reply to Re: mitral valve prolapse and anxiety/depressi « mopey, posted by think2much on August 20, 2003, at 4:43:13
> May I ask how your MVP was diagnosed? I was wondering whether I suffered from it, though I don't know what the test would be. I recently had an ECG though (arrhythmia problems in the family and the doc wanted me to try a trycyclic) and that came back clear.The best diagnostic test is an echocardiogram, with Doppler. The Doppler effect will show if blood is going the wrong way (back into the heart) when the valve should be fully closed.
Lar
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