What are natural treatments for mitral valve prolapse?

Introduction

Mitral valve
prolapse (MVP) affects about 2 percent of people in the
United States. (Past estimates were higher because of errors in diagnosis.) As the
name suggests, MVP involves prolapse (misalignment or the falling out of place) 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 mitral valve prolapse syndrome.
Symptoms were said to include chest pain with no apparent medical cause, panic
attacks and anxiety, heart palpitations, sweating, dizziness, lightheadedness,
weakness, balance problems, hypersensitive startle reflex, shortness of breath,
numbness or tingling in the fingers or toes, hyperventilation, and sensitivity to
caffeine and other stimulants. However, more 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 it probably involves a response
to stress.

Conventional treatment for MVP involves regular monitoring for mitral
regurgitation and maintenance of normal weight and blood pressure to avoid excess
strain on the valve. In addition, people with MVP are given antibiotics
before 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 too.

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 percent of them
had low levels of magnesium in the blood. This subgroup of people with low
magnesium were then enrolled in a ten-week, double-blind, placebo-controlled
crossover trial. (They received placebo or magnesium
supplements for five 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 had 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.

Other Proposed Natural Treatments

Various herbs and supplements that are thought to help the heart in miscellaneous ways (such as treating congestive heart failure or preventing coronary artery disease) are often recommended for MVP too, on general principles. These herbs and supplements include arginine, CoQ10, creatine, hawthorn, L-carnitine, oligomeric proanthocyanidins, 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 treatments include 5-hydroxytryptophan, acupuncture,
hops, kava, lemon balm, melatonin, multivitamin-multimineral supplements,
passionflower, and valerian. Natural treatments used for stress also
may be helpful.

A serious form of autonomic nervous system dysfunction can occur in people with diabetes. The supplements lipoic acid, acetyl-L-carnitine, and gamma-linolenic acid have shown some promise for this condition, and for this reason they have been recommended for the treatment of dysautonomic symptoms.

Herbs and Supplements to Use with Caution

Numerous herbs and supplements may interact adversely with drugs used to treat mitral valve prolapse.

Bibliography

Bobkowski, W., A. Nowak, and J. Durlach. “The Importance of Magnesium Status in the Pathophysiology of Mitral Valve Prolapse.” Magnesium Research 18 (2005): 35-52.

Freed, L. A., et al. “Prevalence and Clinical Outcome of Mitral-Valve Prolapse.” New England Journal of Medicine 341 (1999): 1-7.

Lichodziejewska, B., et al. “Clinical Symptoms of Mitral Valve Prolapse Are Related to Hypomagnesemia and Attenuated by Magnesium Supplementation.” American Journal of Cardiology 79 (1997): 768-772.

Zipes, Douglas P., et al., eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia: Saunders/Elsevier, 2008.