Confronting Mitral Valve Prolapse syndrome

Confronting Mitral Valve Prolapse syndrome

BOOK REVIEW (1988). Confronting MitralValue Prolapse Syndrome. San Marcos, CA Slawson Communications. 182 pp., $12.95 (publisher’s list price). Frede...

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(1988). Confronting MitralValue Prolapse Syndrome. San Marcos, CA Slawson Communications. 182 pp., $12.95 (publisher’s list price). Frederickson, L.


S OUR UNDERSTANDING of biochemical influences on behavior grows, practitioners become increasingly aware of medical conditions mimicking psychiatric symptoms. This book deals with such a condition, occurring in approximately 10% to 20% of the general population. Yet literature is still scarce, and a surprising percentage of the professional community is unaware of the relationship between mitral valve prolapse (MVP) and a number of somatic and psychiatric symptoms .

Lyn Fredrickson states on the cover of her book that this is a practical guide for patient, family, and professional. Her writing style is clear, and her message is focused yet comprehensive. Introducing mitral valve prolapse as a “life-stylethreatening’ ’ cardiovascular condition illuminates for both practitioner and client a poorly understood and often unidentified relationship between the medical problem and the ensuing symptomology that often meets Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM III-R) criteria for some specific neurotic disorders.

The reasons for the lack of research and attention are frankly discussed in the opening chapter, along with a brief overview of the anatomy and physiology of the mitral valve, in lay terms. Chapter 2 discusses the psychological impact of MVP on lifestyles and relationships, an especially poignant chapter for possibly millions of people, primarily women, who have received diagnoses of generalized anxiety disorder, somatization disorder, or panic disorder and have not responded well to standard therapies. Frederickson remains wholly realistic, recognizing that these disorders exist independent of, as well as secondary to, MVP. Her book stands as a source of enlightenment to a large population of inadequately or misdiagnosed “anxiety neurotics. ’ ’ Chapter 3, simply titled “You and Your Physician,” contains some of the most useful information in the book. Without sexist intention, the chapter addresses the frustrations that women typArchives of Psychiatric Nming, Vol. VI, No. 3 (June), 1992:

ically encounter when seeking medical or psychiatric relief from a possible myriad of symptoms secondary to MVP. The chapter recommends a number of approaches to physicians and similarly includes a list of things that tend to alienate them. This is somewhat incongruent with the otherwise straightforward and open approach with which the syndrome is explained and viewed. To illustrate, one suggestion is to avoid proposing that the physician read this book. Considering the author’s credentials (a Masters of Science in Cardiovascular Nursing); her unique position of having personally worked with more than 3,000 cases of MVP; and her instrumental involvement in establishing and now directing America’s first cardiovascular clinic dedicated exclusively to diagnosis, treatment, and rehabilitation of MVP, it does not seem unreasonable to suggest her book to anyone who is treating and unfamiliar with the recognized syndromes and dysautonomia common to a significant number of MVP clients. Chapters 4,5,6, and 7 comprehensively explain the roles that exercise, diet, medication, and mental attitude play in management. The information is geared for the lay person and is particularly encouraging for those whose symptoms have affected their life-styles long enough to have impaired functioning of self-esteem. Chapter 8 deals exclusively with anxiety and panic attacks and their physiological connection to the MVP syndrome. This chapter provides a powerful indictment against formulating treatment strategies until MVP has been ruled out as a possible etiology. Frederickson provides a summary of information necessary for self-management and regaining control of both physical and emotional problems. The author briefly philosophizes, putting MVP and accompanying syndromes into a perspective that somehow tends to elevate not only our awareness, but our humanity as well. The final chapter, 10, answers the 20 most frequently asked questions about MVP. pp. 205-206



Frederickson is a specialist with extensive experience in cardiovascular rehabilitation, and MVP specifically. Her book can be read cover-to-cover in approximately 4 to 5 hours and is organized to offer quick access to well-defined information that may be of particular value to the professional. However, style and content accommodate the lay person. Whereas the link between anxiety, panic, extreme fatigue, and MVP has been quietly recognized for more than a decade, Frederickson provides a thorough overview of these and other symptoms and their effect on life-style. More strikingly, she recognizes and addresses the impact of

professionals on clients who have what often appears to be neurotic somatization. The chapter dealing with how to approach professionals stands as testimony to the need for the information this book offers to become incorporated into current curriculum and practice. This book is highly recommended for anyone dealing with clients with anxiety, panic, learned helplessness, hypersomatic, or depressive issues. Myra Oxhandler, R.N.C., B.S. Masters Candidate, Nursing University of South Florida Tampa, Florida