Only one nutrient, magnesium, is thought to be helpful for symptoms related to mitral valve prolapse. But vitamins that work in conjunction with magnesium, especially vitamin B6, also are often recommended by some experts.
Magnesium: 200-800 milligrams
Vitamin B6: Up to 100 milligrams
If you have been diagnosed with mitral valve prolapse, you should be under a doctor's care.
People with heart problems or kidney problems should take magnesium only under medical supervision.
Take B6 supplements in excess of 100 milligrams per day only under the supervision of your doctor.
Normally, the valves that regulate blood flow through the heart close neatly, snapping shut with the lub-dub sound that we recognize as a heartbeat.
In mitral valve prolapse, however, an additional click--lub-dit-dub--is added to the heartbeat. The extra sound occurs because the valve between the two left chambers of the heart is pushed out of shape by high blood pressure in the compressing heart. The valve pops upward, almost like a parachute being snapped in the wind. The condition happens when one of the fibrous cords that hold the valve in place stretches out too far or when either of the two leaflets that make up the valve is elongated, thickened or floppy. If the valve does not seal perfectly, blood may leak backward, causing the swishing noise that's known as a heart murmur.
"Mitral valve prolapse syndrome is considered a hereditary disorder," explains Kristine Scordo, RN, PhD, assistant professor at Wright State University in Dayton, Ohio, director of the Mitral Valve Prolapse Program of Cincinnati and author of Taking Control: Living with the Mitral Valve Prolapse Syndrome. "People with the disorder--and there are three times as many women as men--are often tall and slender, with long arms and fingers and thin chests."
Although mitral valve prolapse usually causes no life-threatening problems, it has been associated with an array of disturbing symptoms, including heart palpitations, chest pain, shortness of breath, dizziness, fatigue, anxiety, headaches and mood swings. Doctors refer to these collectively as mitral valve prolapse syndrome. "These symptoms aren't caused by the valve itself," Dr. Scordo says. "But they are often part of the package."
These symptoms seem to be caused by disturbances in the body's autonomic nervous system. That's the nervous system that works without conscious control and governs the glands, the heart muscle and the tone of smooth muscles, such as those of the digestive system, the respiratory system and the skin.
"People with mitral valve prolapse often have overreactive autonomic nervous systems," explains Sidney M. Baker, MD, a general practitioner in private practice in Weston, Connecticut, with a special interest in mitral valve prolapse. "Their bodies have a hard time adjusting to changes in the environment. They may be sensitive to light and noise, for instance."
"The symptoms are believed to be caused by a number of physiological changes and can often be helped by dietary changes. In fact, dietary changes are often all that's needed to alleviate symptoms," Dr. Scordo says.
Here's what is recommended.
There's no doubt that minerals play important roles in a properly beating heart. Both the nerves that coordinate the heartbeat and the muscles that contract to move blood through the heart need magnesium in order to do their jobs.
One mineral that has gotten some attention when it comes to mitral valve prolapse is magnesium. Several studies have found that a high percentage of people with mitral valve prolapse have lower than normal magnesium levels.
And one study by researchers at the University of Alabama School of Medicine in Birmingham found that supplemental magnesium relieved many of the symptoms associated with this disorder.
The study, of 94 people with mitral valve prolapse, found that 62 percent of them had low red blood cell levels of magnesium. Those people were also more likely to have additional symptoms: muscle cramps, migraines and a condition called orthostatic hypotension, in which their blood pressure dropped when they first stood up, making them light-headed.
Fifty of the 94 people took 250 to 1,000 milligrams of magnesium daily, in addition to their regular treatment, for four months to four years.
Overall, there was a 90 percent decrease in muscle cramps, a 47 percent decrease in chest pain and a definite decrease in blood vessel spasms in the people taking magnesium, reports the study's main researcher, Cecil Coghlan, MD, professor of medicine at the University of Alabama School of Medicine. Palpitations also were markedly less, and a certain kind of heart arrhythmia called premature ventricular contraction was reduced by 27 percent. People taking magnesium also reported fewer migraines and less fatigue.
Magnesium deficiency can be induced by the very drugs meant to help heart problems, such as digitalis and some types of diuretics (water pills). These drugs cause the body to excrete both magnesium and potassium, leaving people in short supply of these nutrients.
Others most likely to come up short on magnesium, in Dr. Scordo's opinion: those who drink a lot of soft drinks or alcohol, those under stress and anyone eating a poor diet with lots of calories from sugar or fat. "The consensus among magnesium watchers is that it is one of the most prevalent and important deficiencies in North America," according to Dr. Baker. Poor diet is to blame.
"We tell people to make sure that they are getting the Daily Value of magnesium, 400 milligrams, through either foods or supplements," Dr. Scordo says. But because people employ a number of dietary changes to relieve their symptoms, "it's very hard for us to know if the magnesium is helpful or not," she adds.
Dr. Baker recommends from 200 to about 800 milligrams of magnesium a day, along with nutrients that work with magnesium, such as vitamin B6. "People who are going to respond will begin to see improvement in their symptoms within a few days," he says.
Although magnesium is considered to be a fairly safe mineral, even in high doses, people with any heart problems or kidney problems should take supplements only under medical supervision. Too much magnesium could cause a dangerous buildup of the mineral in the blood.
Note that people can have normal blood levels of magnesium and still have short supplies in their tissues. If you are severely deficient, you may benefit by initially getting intravenous magnesium or high oral doses, Dr. Baker says. This treatment, of course, would have to come from your doctor.
Studies show that men get about 329 milligrams of magnesium daily, while women average 207 milligrams. Meats are a good source of magnesium, but for heart-healthy sources, try steamed or broiled halibut and mackerel, rice bran, nuts, seeds, tofu and green, leafy vegetables such as spinach and Swiss chard.
"And since the magnesium that's found in plants depends on the amount of magnesium in the soil, I recommend organically grown produce, which contains a better balance of minerals than produce grown with potassium-rich inorganic fertilizers," Dr. Baker adds.
Unlike magnesium, vitamin B6 can be toxic in large doses. Take B6 supplements in excess of 100 milligrams per day only under the supervision of your doctor.
The following dietary adjustments won't correct a faulty mitral valve. "But they will help relieve many of the symptoms associated with the disorder," explains Kristine Scordo, R.N., Ph.D., assistant professor at Wright State University in Dayton, Ohio, director of the Mitral Valve Prolapse Program of Cincinnati and author of "Taking Control: Living with the Mitral Valve Prolapse Syndrome."
These dietary changes are just as important as any vitamin or mineral supplement that you take, experts say. In fact, two dietary recommendations, less caffeine and less sugar, help your body retain the magnesium it needs.
Junk the java. Some of the most bothersome symptoms of mitral valve prolapse--anxiety, chest pain, shortness of breath--worsen when people consume too much caffeine. "Caffeine is a stimulant and has an adrenaline-like effect, which exaggerates the problems of mitral valve prolapse," Dr. Scordo says. "We tell people to avoid coffee, cola, tea and chocolate altogether, if they can."
Ditch the sweets. That sugar high you've heard of is for real, Dr. Scordo says. Foods that contain sugar that's quickly absorbed, such as candy, cookies, soda and the like, make your body pour out insulin. That greatly increases the activity of the sympathetic nervous system, the body's "accelerator," making symptoms worse.
Go for eight a day. Glasses of water, that is. Again, this is to maintain normal blood pressure. "Even slight dehydration can aggravate symptoms of light-headedness and dizziness," Dr. Scordo says. "Most people can alleviate these symptoms in about two weeks just by getting enough fluids and salt."
Diet with care. Crash diets and fad diets aren't just ineffective in the long run. Most of the initial weight loss that's achieved is through water loss, just the opposite of what someone with mitral valve prolapse symptoms needs. If you do need to lose weight, doctors suggest going for a steady one pound a week.
This page was first uploaded to The Magnesium Web Site on November 23, 2002