DRHOOK- Not so valuable: Heart problem a different kind of MVP

the handsome doctor John Hong

Most people think MVP stands for "Most Valuable Player," but not me. I don't watch any sports except figure skating and gymnastics during the Olympics, and tennis. (BTW, Kim Yu Na is the Olympic Gold Medalist in figure skating. Go, Korean sista, go!) 

Back to MVP: should there really be such an honor? Why do they call it a "team" sport if some team members are more valuable than others? Could the MVP really be that great if the rest of the team stinks? Can a quarterback be great if the receivers can't catch? Can a basketball player dunk the ball if his teammates can't get it to him? Can Tiger Woods swing his club without all his women? 

 What happens if your heart has MVP?

 The mitral valve sits between the heart's left atrium and left ventricle. When the left ventricle pumps blood to the body, the mitral valve closes to prevent pumping back into the left atrium. However, due to a sort of manufacturing defect in some people, the mitral valve can swing open (prolapse) into the left atrium like a swinging kitchen door in a restaurant— that's MVP. 

 Interestingly, quite a few symptoms can be associated with MVP, although it's hard to know what percentage of folks with MVP have symptoms. The primary symptom is palpitations: feeling your heart pound. Palpitations can be quite fast and cause the blood pressure to drop. Ergo, lightheadedness and even fainting can occur. Rarely, MVP can cause a deadly arrhythmia. 

 People with MVP tend to have lower systolic blood pressure (the top number). (The bottom number is diastolic blood pressure.) People with MVP also tend to be thin with some bony abnormalities of the chest (think of Kate Moss). 

 Chest pains with MVP are not like angina (a pressure feeling like an elephant standing on the chest that radiates down the left arm, shortness of breath, sweating). Still, coronary artery disease has to be considered in people with chest pain. Shortness of breath and a lax (or non-existent) exercise routine can contribute to MVP, but ironically, steady routine exercise has been shown to alleviate the symptoms. (Of course, a person has to gradually build up to getting in shape. It doesn't occur overnight, which is one reason most people quit.)

 What about panic attacks and anxiety associated with MVP? I don't know what to think about this because studies are conflicting, and there's a lot of bias in the studies. It seems feasible because folks with MVP have higher catecholamine levels (the "fright or flight" chemicals that rev you up during stress). So having MVP could be like drinking a Venti coffee all day long (which is why avoiding caffeine is a good idea for those with symptomatic MVP). 

Palpitations can also be "the chicken or the egg" question because it's not clear whether anxiety causes the palpitations or palpitations make the person anxious. When your heart is racing for no reason, it can be very unnerving. 

 Hyperventilation with MVP can cause paresthesia (numbness, tingling) around the mouth and other body parts. Also hyperventilation can cause lightheadedness and a feeling of distress with breathing.

 A cardiologist can diagnose MVP. Some people with MVP are at increased risk of mitral valve infection. Medications might also be warranted for some.

 Well, I think those who have the biggest heart all deserve an MVP award: Most Valuable Persons. That's probably worth more than any sports award there is.


Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.