This is a condition of the mitral valve, a two flapped heart valve between the left atrium and left ventricle. One or both of the valve flaps may be too large and the mitral valve does not close evenly with each heartbeat. With this imperfect close, the valve slightly balloons back into the left atrium (causing a “click”). With the flap, there may be a slight backward leaking of blood (regurgitation) and a heart murmur. In most cases it is harmless and does not cause symptoms or need to be treated. In a few cases it can cause severe mitral regurgitation and needs to be treated. This is the most common heart valve abnormality and affects 5 to 20% of the population. It is more commonly found in women and often diagnosed between the ages of 20 and 40.
Approximately 60% of individuals never exhibit any symptoms. Some symptoms that may present include irregular heartbeat or palpitations, fast heart rate (often after exertion), nonspecific chest pain (unrelated to coronary artery disease or a heart attack), panic attack, a sudden feeling of anxiety or doom, difficulty breathing after exertion or lying flat, fatigue and weakness (even after slight exertion), or even headaches.
Mitral valve prolapse can be caused by many different things. Mitral valves that are structurally abnormal can raise the risk for bacterial infection. Some forms of mitral valve prolapse seem to be passed down through families (inherited). Mitral valve prolapse has been associated with Graves disease.
It often affects thin women who may have minor chest wall deformities, scoliosis, or other disorders.
Mitral valve prolapse is associated with some connective tissue disorders, especially Marfan syndrome. Other conditions include:
- Ehlers-Danlos syndrome
- Osteogenesis imperfecta
- Polycystic kidney disease
How it is Diagnosed:
The doctor may feel a thrill (vibration) over the heart or may hear a murmur using a stethoscope. The murmur is usually increased when standing. Blood pressure is normal. Mitral valve prolapse may show on an echocardiogram, doppler examination, or cardiac catheterization. Additional tests may be ordered to determine how the heart responds under stress. An exercise stress test may be ordered. To identify rhythm abnormalities, a holter monitor may be recommended.
In most cases there are no or few symptoms and treatment is not needed. There are no restrictions on activity or diet. Regular check ups every 3 to 5 years is recommended. If you have palpitations, you should limit your caffeine intake and quit smoking. Beta blocker medications may be used to relieve palpitations, chest pain, and/or anxiety related to the MVP or to control atrial fibrillation (a rhythm irregularity). Beta blockers minimize the effects of stress hormones on cardiovascular functions, slowing the heart rhythm and minimizing the stretch on the floppy mitral valve. If atrial fibrillation is present, blood thinners may be used to prevent clot formation. Surgery is only needed if there is severe mitral regurgitation with the mitral valve prolapse.