Mitral Valve Prolapse

Mitral valve prolapse is when the valve that separates the upper and lower chambers of the left side of the heart does not close properly. The mitral valve helps blood on the left side of the heart flow in one direction. It closes to keep blood from moving backwards when the heart beats (contracts).

In a small number of cases, prolapse can cause blood to leak backwards, also known as mitral regurgitation.

Symptoms

In most cases, mitral valve prolapse is harmless and patients usually don’t know they have a problem. Some forms of mitral valve prolapse are inherited, while others occur with connective tissue disorders like Marfan syndrome or other rare genetic disorders. It usually occurs in thin women who have minor chest wall deformities, scoliosis, or other disorders.

Symptoms include:

  • Chest pain (not caused by coronary artery disease or a heart attack)
  • Dizziness
  • Fatigue
  • Panic attacks
  • Sensation of feeling the heart beat (palpitations)
  • Shortness of breath with activity or when lying flat (orthopnea).

Diagnosis: Exams and Tests

The doctor will perform a physical exam and use a stethoscope to listen to your heart and lungs. The doctor may feel a thrill (vibration) over the heart, and hear a heart murmur ("midsystolic click"). The murmur gets longer and louder when you stand up.

Blood pressure is usually normal.

Echocardiogram is the most common test used to diagnose mitral valve prolapse. The following tests may also be used to diagnose mitral valve prolapse or a leaky mitral valve:

  • Cardiac catheterization
  • Chest x-ray
  • CT scan of the chest
  • ECG (may show arrhythmias such as atrial fibrillation)
  • MRI of the heart

Treatment

In rare cases, patients may need surgery to repair or replace the mitral valve if blood starts to regurgitate, or leak backwards. Surgery may also require replacement if symptoms or heart function worsen, or if the left ventricle of the heart becomes enlarged.

Some arrhythmias or abnormal heart beats can be life-threatening for people with mitral valve prolapse.

Patients with prolapse may need antibiotics before dental work or other invasive procedures, like colonscopy, and should consult their doctors before undergoing any type of procedure.

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