In patients with MVPS, valvular disease alone cannot explain their symptoms, including weakness, fatigue, migraine, dizziness, orthostatic hypotension, dyspnea, palpitations, or nonanginal chest pain. They often have higher than normal levels of 24-hour urinary epinephrine. These patients also tend to have increased serum levels of catecholamines 6 such as epinephrine and norepinephrine, which have a marked effect on nervous and cardiovascular systems, metabolic rate, temperature, and smooth muscle. When symptoms do appear, it is often after a major physiological stressor such as childbirth or emotional changes such as divorce, a death in the family, or job pressures. The irregular heartbeat of MVP-anatomic and MVPS may be experienced as palpitations or a fluttering in the chest.
Some patients feel that their heart has stopped for a few seconds.
They may have tachycardia, or a feeling that their heart is pounding. It usually occurs at rest but sometimes after exercise. MVPS patients who have chest pain may be frightened because they think they're having a heart attack. Unlike angina pain, the chest pain of MVPS is not caused by narrowed or blocked arteries and does not damage the cardiac muscle. The pain may be due to a stretching of the chordae tendineae and papillary muscles during prolapse or to subendocardial ischemia.