Mitral valve prolapse (MVP) is the bulging (or prolapse) of one or both of the mitral valve flaps into the left atrium when the heart contracts. When the flaps do not close properly, blood leaks backward. This is called regurgitation. Regurgitation may result in a heart murmur, an abnormal sound in the heart caused by turbulent blood flow. When regurgitation is present, it’s generally mild although it can progress into a more serious condition over time.
The mitral valve is located between the left atrium and the left ventricle and has 2 flaps. Normally the flaps are tightly closed by small tendon or "cords" that connect the flaps to the muscles of the heart. This closure prevents blood from flowing backwards. In MVP, the flaps enlarge and stretch inward toward the left atrium, sometimes "snapping" during heart contraction. This may allow some backflow or regurgitation of blood into the left atrium.
MVP usually does not need to be treated because it is rarely a serious condition, and it does not damage the heart. However, regular checkups with a doctor are advised.
The cause of MVP is unknown, but it’s thought to be inherited. There are 2 forms of MVP: primary and secondary.
Primary MVP means the mitral valve is abnormal because of one or more of these changes:
Primary MVP is seen in people with Marfan syndrome and other inherited connective tissue diseases. But, it’s most often found in people with no other form of heart disease.
In secondary MVP, the flaps are not thickened but rather prolapse occurs for other reasons. The prolapse or bulging may be due to:
MVP affects both sexes and people of all ages. Factors that may increase the risk of MVP include:
MVP may not cause any symptoms. Symptoms may vary depending on the degree of prolapse present. The presence of symptoms does not necessarily match the severity of MVP.
These are the most common symptoms of MVP:
Depending on the severity of the mitral regurgitation or leak, the left atrium or left ventricle may become enlarged, leading to symptoms of heart failure. These symptoms include weakness, tiredness, dizziness, and shortness of breath.
The symptoms of mitral valve prolapse may look like other medical conditions or problems. Always see a doctor for a diagnosis.
You may have no noticeable symptoms. Your doctor may hear a click or murmur during a routine physical exam. The "click" is created by the stretched flaps snapping against each other during contraction. The murmur is caused by the blood leaking back into the left atrium. This may be the only sign of MVP.
Along with a complete medical history and physical exam, your doctor may order these tests to diagnose MVP:
For more severe symptoms, other tests may be done. These may include:
Your healthcare provider will figure out the best treatment based on:
MVP usually does not need to be treated because it is rarely a serious condition, and it does not damage the heart. Regular checkups with your doctor are advised.
If you have heart rhythm changes, you may need medicines that control fast heart rhythms or irregular heartbeats. In most cases, you will also need to limit stimulants, such as caffeine and cigarettes, to control symptoms.
If you have atrial fibrillation or severe left atrial enlargement, you may need treatment with an anticoagulant (blood thinner) to keep clots from forming. This can be in the form of aspirin or warfarin (Coumadin) therapy.
If you have symptoms of dizziness or fainting, it is important to stay well hydrated by drinking plenty of fluids.
If severe mitral regurgitation is due to a floppy mitral leaflet, rupture (tear) of the cords, or extreme lengthening of the valve, you may need surgical repair, or valve replacement.
Rarely, bacteria that enter the bloodstream can cause endocarditis, an infection of the inner lining of the heart chambers and valves. This risk is higher in people with MVP because the deformed mitral valve flap can attract bacteria that are in the bloodstream. Gum infections and tooth decay can cause endocarditis, so regularly flossing and brushing your teeth can help prevent it. People at high risk for endocarditis (such as those who have had a valve replaced) may be given antibiotics before dental work and certain types of surgery.
Call your healthcare provider if your symptoms get worse or if you have new symptoms.
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