Some patients with mitral valve prolapse (MVP, floppy valve) are asymptomatic but others may have prominent symptoms some of which may be due to autonomic dysfunction (dysautonomia). Some symptoms may precede detectable deformity of the valve.
Mechanisms may include (1) hypersensitivity of beta adrenergic receptors, (2) increased release of catecholamines or (3) abnormal central modulation of baroreflexes.
Clinical findings may include:
(1) poor exercise tolerance
(2) orthostatic hypotension
(3) anxiety
(4) palpitations
(5) tachycardia
(6) prolonged bradycardia during the recovery phase of the Valsalva maneuver
(7) chest pain
(8) cardiac arrhythmias
(9) syncope or presyncope
(10) dyspnea
(11) greater respiratory variation of the R-R interval
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