Mitral Valve Prolapse

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What is the mitral valve?

The mitral valve is the heart valve that separates the upper and lower chambers of the left side of the heart (the left atrium and left ventricle). It is composed of two leaflets of tissue. When the mitral valve opens, blood flows from the left atrium into the left ventricle. The valve then closes when the left ventricle contracts. When closed properly, blood is prevented from leaking back through the valve. The opening and closing produce the heart sounds that your doctor hears when listening with a stethoscope.

What is mitral valve prolapse (MVP)?

In mitral valve prolapse, the valve does not close properly. Instead of closing smoothly and forming a flat surface, the valve leaflets bulge (prolapse) into the left atrium. This bulging can produce a clicking sound that your doctor might hear during an examination with a stethoscope. Significant prolapse can keep the valves from closing and allow blood to leak back throught the valve.

Who is at risk?

By various sources mvp has been estimated to affect anywhere from 5% to 20% of the population. It can be caused by a stretching and thickening of the valve leaflets. It can also be associated with genetic diseases of the connective tissue, like Marfan’s syndrome and Ehlers-Danlos syndrome.

MVP is seen mostly commonly in women, particularly thin women with minor deformities of the chest wall. MVP appears to have a strong hereditary tendency.

Prolapse can also occur if the muscles involved in supporting the valve are damaged by a heart attack.

What are the symptoms?

Most people with MVP experience no obvious symptoms. Some symptoms associated with MVP include palpitations (feeling your heart beat), shortness of breath, chest pain, fatigue and cough. Anxiety and panic attacks have been associated with MVP. MVP can be associated with a sudden speeding up of the heart rate and a “pounding” known as tachycardia. People with MVP sometimes have low energy levels.

How is it diagnosed?

The doctor will perform a thorough physical exam, including palpation (examining bodily organs using touch) and listening to your heart sounds with a stethoscope. The doctor will listen for a clicking sound during beating, followed by a murmur. The murmur is more prominent while standing, so your doctor may ask you to sit, stand, or lie down while listening.

An echocardiogram is commonly used to diagnose MVP. This is a painless, noninvasive test that uses sound waves to make a picture of your heart. Other tests your doctor might rarely use include: Chest X-ray, Coronary Angiography, ECG, MRI, CT scan or nuclear medicine scans.

What are the complications?

The risk of complications is very low. Mitral regurgitation (blood leaking backward through the valve) can occur in a very few cases with significant prolapse. Mitral regurgitation can become worse, particularly in men. It could progress to a point where surgery is required to replace the valve. On rare occasions, MVP can be associated with congestive heart failure, stroke, and infective endocarditis. The doctor may prescribe antibiotics with certain procedures to reduce the risk of infection. Heart rhythm abnormalities are common. Most are minor and of no concern except when they cause symptoms.

What is the treatment?

The first part of the treatment is education and reassurance. Patients with no symptoms or few symptoms usually require no treatment at all. Severe prolapse and regurgitation can require surgery to replace the faulty valve. If you have irregular heartbeat, the doctor may prescribe medicine to improve this. Antibiotics are sometimes prescribed prior to medical procedures that could introduce infection, like insertion of instruments or tubes into your body or dental procedures.

Please ask us any questions you might have about this condition.