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Overview
What is mitral valve prolapse?
Mitral valve prolapse (MVP) occurs when the leaflets of the mitral valve bulge backwards into the left atrium during contraction of the left ventricle. It is caused by an underlying structural abnormality of the mitral valve.
Normally, when the heart beats, blood is first pumped through the mitral valve from the left atrium into the left ventricle. The valve acts like a gate, allowing blood to flow in only one direction, from the upper to lower chamber (left atrium to left ventricle). When the left ventricle contracts to pump blood to the body, the mitral valve closes to prevent blood leaking back into the left atrium, and so the blood is expelled from the heart to the rest of the body.
If you have mitral valve prolapse, the valve flaps bulge backward into the left atrium. Usually, the effect on your heart is minor because the seal between the two heart chambers is tight enough to prevent leakage. In this case, you won't have any symptoms or need treatment. However, if the valves don't seal tightly, blood could leak back into the left atrium, a condition called mitral valve regurgitation. In most cases of MVP, this doesn't happen.
See illustrations of:
- The heart and its chambers, valves, and blood flow.
- An open and closed mitral valve.
- Mitral valve prolapse.
- Is mitral valve prolapse a serious condition?
If there are no existing complications, mitral valve prolapse is not life-threatening. MVP is the most common heart valve abnormality in the United States.
What are the possible complications of mitral valve prolapse?
People who have mitral valve prolapse fall into three categories:
- Those who have MVP that requires no treatment or is not a cause for concern. The overwhelming majority of people with MVP have this type.
- Those who are at risk for developing complications because of the anatomy of their mitral valve or genetic reasons.
Those who have complications that require treatment and follow-up. Complications, which are rare, include:
- An infection of your heart called endocarditis.
- Thickening and stiffening of the mitral valve flaps. This may cause blood to leak backwards into the upper chamber (left atrium), causing mitral valve regurgitation.
- If you have severe mitral valve regurgitation, your left ventricle may become enlarged, which could ultimately lead to heart failure.
- Irregular or rapid heart rhythms (arrhythmia).
- Formation of a blood clot that causes a transient ischemic attack (TIA) or stroke
Mitral valve prolapse has also been called floppy valve syndrome, Barlow's syndrome, and click-murmur syndrome.
What causes mitral valve prolapse?
Mitral valve prolapse is mostly an inherited (genetic) condition.1 Other conditions, which may or may not be inherited, can cause MVP. These include:
- Marfan's syndrome or lupus.
- Other heart valve defects, rheumatic heart disease, endocarditis, or diseases of the blood vessels supplying the heart (coronary artery disease).
- Hyperthyroidism.
- Ehlers-Danos syndrome.
- Osteogenesis imperfecta.
What are the symptoms of mitral valve prolapse?
For most people with mitral valve prolapse, the effect on the heart is minor, and there are no symptoms. Some people with MVP tell their doctors that they have shortness of breath, chest pain, or heart palpitations. These are not proven symptoms of mitral valve prolapse. Many experts believe that such symptoms may be related to anxiety that people feel after being told they have a heart problem, or that the symptoms may be caused to another condition.
People who have severe mitral valve regurgitation as a complication of MVP may develop symptoms of heart failure, which include shortness of breath, fluid buildup (edema), and fatigue.
What tests will I need for mitral valve prolapse?
A medical history and physical exam are used to initially diagnose mitral valve prolapse. Your doctor may want you to have an echocardiogram to confirm the diagnosis, or if he or she suspects you have mitral valve regurgitation as a complication. If you have mitral valve prolapse with no symptoms and no complications, however, you will probably only need a checkup with your doctor every 3 to 5 years.
What kind of treatment will I need for mitral valve prolapse?
If you have mitral valve prolapse without any symptoms or complications, you will not need treatment. If you have symptoms or complications, you may be treated with medications, including Aspirin, beta-blockers, antiarrhythmics, and warfarin. If you have mitral valve regurgitation in addition to or as a complication of mitral valve prolapse, you may need surgery to repair or replace the valve.
If you have mitral valve regurgitation or thickened valve leaflets, you are at risk for developing endocarditis. In order to prevent this heart infection, your doctor may want you to take antibiotics before certain medical or dental procedures. Some doctors, however, may feel antibiotics are worthwhile even if you do not have mitral valve regurgitation. If you do develop endocarditis, you will need intravenous (IV) antibiotics.
