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Mitral Valve Prolapse by Michelle Badash, MS

Definition

Mitral valve prolapse (MVP) is a common, usually benign heart disorder. The mitral valve controls blood flow between the upper (atrium) and lower (ventricle) chambers on the left side of the heart. Normally, blood should only flow in one direction, from the upper chamber into the lower chamber. In MVP, the valve flaps don’t work properly; part of the valve balloons into the atrium, which may be associated with blood flowing in the wrong direction, or leaking back into the atrium.

Prolapsed Mitral Valve

Causes

In most cases, the cause of MVP is unknown. In some cases, it appears to be an inherited genetic condition. Rarely, MVP may be caused by:

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Family history of mitral valve prolapse
Sex: female
Age: 14 to 30
Scoliosis
Thin chest diameter
Low body weight
Low blood pressure
Chest wall deformities
Marfan syndrome
Grave’s disease

Symptoms

People with mitral valve prolapse often have no symptoms at all. If symptoms do occur, however, they may include one or more of the following:

Irregular heart beat
Fatigue
Chest pain
Panic attacks or anxiety
Rapid heart beat (palpitations)
Sensation of missed heart beats
Shortness of breath
Dizziness
Intestinal problems (such as irritable bowel syndrome )

Diagnosis

Mitral valve prolapse can be heard through a stethoscope. A small blood leakage will sound like a murmur. When the mitral valve balloons backward, it may produce a clicking sound. Both murmurs and clicks are telltale signs of MVP. An echocardiogram can confirm the diagnosis. You may also be asked to wear a Holter monitor for a day or two to continuously record the electrical activity of your heart (EKG).

Treatment

In most cases, no treatment is necessary. Speak with your doctor about whether you should take antibiotics prior to dental work or surgery. Antibiotics may help to prevent endocarditis , an infection of the membrane that covers the inside of the heart.

If symptoms include chest pain, anxiety, or panic attacks, a beta-blocker medication can be prescribed. Ask your doctor whether you may continue to participate in your usual athletic activities.

In very rare cases, the blood leakage may become severe. In these few cases, the mitral valve may need to be surgically repaired or replaced.

Prevention

There are no guidelines for preventing MVP of unknown or genetic origin.

You may be able to prevent symptoms, however, through certain lifestyle changes:

Limit your intake of caffeine .
Avoid medications (such as decongestants) that speed up your heart rate.
Exercise regularly , following your healthcare provider’s recommendations for intensity.

RESOURCES:

American Heart Association http://www.americanheart.org/
National Library of Medicine http://www.nlm.nih.gov/

CANADIAN RESOURCES:

Canadian Cardiovascular Society http://www.ccs.ca/
Canadian Family Physician http://www.cfpc.ca/cfp/

References:

American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 . Accessed July 17, 2009.
Mitral valve prolapse. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/mitral-valve-prolapse/DS00504 . Updated June 2009. Accessed July 17, 2009.
National Heart, Lung, & Blood Institute website. Available at: http://www.nhlbi.nih.gov/ . Accessed July 17, 2009.

Last reviewed November 2009 by David N. Smith, MD

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