Mitral Valve Prolapse

The flaps of the valve are “floppy” and don’t close tightly. Most people who have the condition are born with it. It also tends to run in families.

Most of the time, MVP doesn’t cause any problems. Rarely, blood can leak the wrong way through the floppy valve. This can cause

• Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or too fast)
• Shortness of breath
• Cough
• Fatigue, dizziness, or anxiety
• Migraine headaches
• Chest discomfort

Most people who have mitral valve prolapse (MVP) don’t need treatment because they don’t have symptoms and complications. If you need treatment for MVP, medicines can help relieve symptoms or prevent complications. Very few people will need surgery to repair or replace the mitral valve.

MVP puts you at risk for infective endocarditis, a kind of heart infection. To prevent it, doctors used to prescribe antibiotics before dental work or certain surgeries. Now, only people at high risk of endocarditis need the antibiotics.

Prevention

You can’t prevent mitral valve prolapse (MVP). Most people who have the condition are born with it.

Complications from MVP, such as arrhythmias and infective endocarditis (IE), are rare. IE is an infection of the inner lining of your heart chambers and valves.

People at high risk for IE may be given antibiotics before some types of surgery and dental work. Antibiotics can help prevent IE. Your doctor will tell you whether you need this type of treatment.

People at high risk for IE may include those who’ve had valve repair or replacement or who have some types of underlying heart disease.

Risk Factors

Mitral valve prolapse (MVP) affects people of all ages and both sexes; however, aging raises the risk of developing the disease.

CERTAIN CONDITIONS HAVE BEEN ASSOCIATED WITH MVP, INCLUDING:

• A history of rheumatic fever
• Connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome
• Graves’ disease
• Scoliosis and other skeletal problems
• Some types of muscular dystrophy

Causes

The exact cause of mitral valve prolapse (MVP) isn’t known. Most people who have the condition are born with it. MVP tends to run in families. Also, it’s more common in people who are born with connective tissue disorders, such as Marfan syndrome.

IN PEOPLE WHO HAVE MVP, THE MITRAL VALVE MAY BE ABNORMAL IN THE FOLLOWING WAYS:

• The valve flaps may be too large and thick.
• The valve flaps may be “floppy.” The tissue of the flaps and their supporting “strings” are too stretchy, and parts of the valve flop or bulge back into the atrium.
• The opening of the valve may stretch.

These problems can keep the valve from making a tight seal. Some people’s valves are abnormal in more than one way.

Symptoms

Most people who have mitral valve prolapse (MVP) aren’t affected by the condition. They don’t have any symptoms or major mitral valve backflow.

WHEN MVP DOES CAUSE SIGNS AND SYMPTOMS, THEY MAY INCLUDE:

• Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or too fast)
• Shortness of breath
• Cough
• Fatigue, dizziness, or anxiety
• Migraine headaches
• Chest discomfort

MVP symptoms can vary from one person to another. They tend to be mild but can worsen over time, mainly when complications occur.

Diagnosis

Mitral valve prolapse (MVP) most often is detected during a routine physical exam. During the exam, your doctor will listen to your heart with a stethoscope.

Stretched valve flaps can make a clicking sound as they shut. If the mitral valve is leaking blood back into the left atrium, your doctor may heart a heart murmur or whooshing sound.

However, these abnormal heart sounds may come and go. Your doctor may not hear them at the time of an exam, even if you have MVP. Thus, you also may have tests and procedures to diagnose MVP.

DIAGNOSTIC TESTS AND PROCEDURES

Echocardiography (echo) is the most useful test for diagnosing MVP. This painless test uses sound waves to create a moving picture of your heart.

Treatment

Most people who have mitral valve prolapse (MVP) don’t need treatment because they don’t have symptoms and complications.

Even people who do have symptoms may not need treatment. The presence of symptoms doesn’t always mean that the backflow of blood through the valve is significant.

People who have MVP and troublesome mitral valve backflow may be treated with medicines, surgery, or both.

MEDICINES

Medicines called beta blockers may be used to treat palpitations and chest discomfort in people who have little or no mitral valve backflow.

SURGERY

Surgery is done only if the mitral valve is very abnormal and blood is flowing back into the atrium. The main goal of surgery is to improve symptoms and reduce the risk of heart failure.

The timing of the surgery is important. If it’s done too early and your leaking valve is working fairly well, you may be put at needless risk from surgery. If it’s done too late, you may have heart damage that can’t be fixed.

Traditionally, heart surgeons repair or replace a mitral valve by making an incision in the breastbone and exposing the heart.

Recovery

Most people who have mitral valve prolapse (MVP) have no symptoms or related problems, do not need treatment, and are able to lead normal, active lives. If symptoms and complications do occur, most often you can control them with medicines. However, some people may need transcatheter valve therapy or heart valve surgery to relieve their symptoms and prevent complications. Rarely, mitral valve prolapse can cause arrhythmias and other problems.