- Knowledgebase: Information on Specific Illnesses
- Here you will find discussions of specific illnesses and their management.
- 49. Mitral Valve Prolapse - Top
- Definition
A disorder in which the mitral heart valve billows out and does not close properly, allowing blood to leak (backflow) into the left atrium.
Causes, Incidence and Risk Factors
Mitral valve prolapse (MVP) is one cause of mitral regurgitation (leakage of blood from insufficient valve closure). It occurs in about 2 out of 1,000 people overall. (It affects about 5 to 7% of women between 14 and 30 years old).
Mitral valve prolapse is a common syndrome with a wide range of symptoms. Some forms of MVP seem to be hereditary. MVP has been associated with Marfan's syndrome characteristics.
Most individuals with mitral valve prolapse are thin women who may have minor chest wall deformities, scoliosis, or other disorders. There may also be an atrial septal defect high in the wall of the heart (callled an ostium secundum defect). Other risk factors include pregnancy (it causes an increased blood volume and increased workload on the heart), fatigue or overwork.
Symptoms
sensation of feeling the heart beat (palpitations)
chest pain (unrelated to coronary artery disease or myocardial infarction)
difficulty breathing after exertion
fatigue
cough
shortness of breath when lying flat (orthopnea)
Note: In some cases, there may be no symptoms or there may be a gradual onset of symptoms.
Signs And Tests
Palpation may reveal a thrill (vibration) over the heart. A stethoscopic of the heart may reveal a distinctive murmur or other abnormal sounds. (The murmur is described as a mid-systolic click followed by a late systolic murmur. This means a click sound is heard midway in the "beating" part of the heartbeat cycle, follwed by a murmur near the end of this time.) The murmur is worse when standing. If fluid backs up into the lungs, there may be signs of congestion of the pulmonary (lung) veins such as crackles. Blood pressure is usually normal.
An echocardiogram may show mitral valve prolapse.
Coronary angiography may show MVP or mitral regurgitation.
Chest X-rays may show fluid in the lungs or lung veins, or an enlarged left atrium.
An ECG is usually normal but may show arrhythmias such as atrial fibrillation (rapid insufficient contractions).
Other tests may include ultrasound, chest MRI, radionucleotide scans, or a CT scan of the chest.
Treatment
In most cases there are no or few symptoms, and mitral valve prolapse does not require treatment. There are no restrictions on activity or diet. Hospitalization may be required for diagnosis or treatment of severe symptoms.
Surgical repair or valve replacement improves symptoms. Surgery may be required if heart function is poor, if symptoms are severe, or if condition deteriorates.
Antibiotics are prescribed if bacterial infection is present. Antiarrhythmics may be needed to control irregular heart rhythms. Vasodilators reduce the workload of the heart. Digitalis may be used to strengthen the heartbeat and diuretics used to remove excess fluid in the lungs. Analgesics or propranolol may be given for chest pain. Anticoagulants may be used to prevent clot formation if atrial fibrillation is present (atrial fibrillation increases the chances of clot formation).
Expectations (Prognosis)
The outcome varies depending on underlying conditions. Mitral valve prolapse is usually benign and without symptoms. When symptomatic, it is controllable with medications and may be improved with surgery.
Complications
endocarditis
heart failure
pulmonary emboli
stroke
clots to other areas
arrhythmias, including atrial fibrillation and lethal arrhythmias
Calling Your Health Care Provider
Call for an appointment with your health care provider if symptoms are suggestive of mitral valve regurgitation.
Call your health care provider if signs of infection occur during treatment: fever, chills, muscle aches, headache, malaise (general ill feeling).
Prevention
Discuss any history of heart valve disease or congenital heart disease before treatment by the health care provider or dentist. Any dental work, including cleaning, and any invasive procedure can introduce bacteria into the bloodstream. This bacteria can infect a damaged mitral valve causing endocarditis. Antibiotic prophylaxis (giving antibiotics to prevent infections rather than waiting for infection to develop) is recommended for individuals with mitral valve prolapse when a significant regurgitation is documented.
The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.
- Updated: March 5, 2001
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