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. But, if regurgitation is present, it’s generally mild.
The mitral valve is located between the left atrium and the left ventricle and is made of two flaps. Normally the flaps are tightly closed by the chordae tendineae , which are small tendon "cords" that connect the flaps to the muscles of the heart). In MVP, the flaps enlarge and stretch inward toward the left atrium, sometimes "snapping" during heart contraction, and 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 two forms of MVP: primary and secondary.
Primary MVP means the mitral valve is abnormal because of one or more of these changes:
The primary form of 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. 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 following are the most common symptoms of MVP. However, each person may experience symptoms differently. Symptoms may include:
Depending on the severity of the mitral regurgitation or leak, the left atrium and/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 resemble other medical conditions or problems. Always see a doctor for a diagnosis.
People with MVP often have no noticeable symptoms and a click or murmur may be heard 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. The click or murmur may be the only sign of MVP.
Along with a complete medical history and physical exam, tests used to diagnose MVP may include:
In some cases where symptoms are more severe, more tests may be done. These may include:
Specific treatment for MVP will be determined by your health care provider based on the following:
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 a doctor are advised.
People with heart rhythm changes may need to be treated with medicines to control fast heart rhythms. In most cases, limiting stimulants, such as caffeine and cigarettes, is all that is needed to control symptoms.
If atrial fibrillation or severe left atrial enlargement is present, treatment with an anticoagulant (blood thinner) may be recommended to keep clots from forming. This can be in the form of aspirin or warfarin (Coumadin) therapy.
For the person with symptoms of dizziness or fainting, staying well hydrated (keeping enough fluid in the body and blood vessels) is important.
If severe mitral regurgitation is due to a floppy mitral leaflet, rupture (tear) of the chordae tendineae, or extreme lengthening of the valve, surgical repair may be needed.
MVP is usually harmless and does not shorten life expectancy. Healthy lifestyle behaviors and regular exercise are encouraged.
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.
You should notify your health care provider if your symptoms get worse or if you have new symptoms.
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