From the Guidelines
Mitral valve prolapse (MVP) does not typically cause acute, stabbing chest pain, and if you're experiencing this type of pain, you should seek immediate medical attention as it could indicate a more serious condition. According to the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain 1, chest pain may occur in the presence of valvular heart disease (VHD), but it is more commonly associated with stenotic VHD, such as aortic valve stenosis and mitral valve stenosis with secondary pulmonary hypertension.
When symptoms do occur in patients with mitral valve prolapse, they tend to be mild and may include:
- Heart palpitations
- Mild chest discomfort (not usually sharp or stabbing)
- Fatigue
- Shortness of breath Acute, stabbing chest pain is more commonly associated with other heart conditions like angina, heart attack, or pericarditis, as noted in the European Heart Journal 1. It could also be caused by non-cardiac issues such as muscle strain, acid reflux, or lung problems.
If you have known valve prolapse and are experiencing new or worsening symptoms, especially severe pain, it is essential to contact your healthcare provider promptly. They may recommend tests like an ECG, echocardiogram, or stress test to evaluate your heart function and rule out other potential causes of your symptoms. The 2021 guideline 1 suggests that transthoracic echocardiography (TTE) is a useful first-line test to determine the presence, severity, and cause of VHD.
In cases where TTE images are technically inadequate, transesophageal echocardiography (TEE) with 3D images or cardiac magnetic resonance (CMR) may be useful to objectively assess the severity and cause of VHD 1. Remember, chest pain should always be taken seriously, regardless of whether you have a pre-existing heart condition, and when in doubt, it's best to seek medical evaluation to ensure proper diagnosis and treatment.
From the Research
Causes of Acute Chest Pain
- Acute chest pain can be caused by several cardiac disorders or disorders of the great vessels, including acute coronary syndromes (ACS) and ascending aortic dissections 2, 3, 4, 5
- Noncardiac causes of chest pain can include functional abnormalities, gastroesophageal reflux disease, panic disorder or anxiety states, and costochondritis 3, 4, 6
Characteristics of Chest Pain
- Cardiac causes of chest pain usually have anginal symptoms, while noncardiac causes can have a variety of chest pain characteristics 3
- The type of chest pain can predict the likelihood of coronary artery disease as the cause of chest pain 4
Evaluation of Acute Chest Pain
- Initial evaluation of acute chest pain is based on determining whether the patient needs to be referred to a higher level of care to rule out acute coronary syndrome (ACS) 4, 5
- A combination of age, sex, and type of chest pain can predict the likelihood of coronary artery disease as the cause of chest pain, and risk scores such as the Marburg Heart Score and the INTERCHEST clinical decision rule can help estimate ACS risk 4, 5