Mitral valve prolapse, or MVP for short, is a common disorder that impacts two to three percent of the general population. It is a common cause of heart murmurs due to a leaky heart valve, but it has also been linked to other conditions. There is still a lot that is unknown about this disorder, so research is ongoing. To date, medical scientists have been able to pinpoint typical symptoms and provide preventative tips when it comes to MVP.
The mitral valve is, in fact, a valve that lets the blood flow from one chamber of the heart (left atrium) to another (left ventricle). When someone experiences mitral valve prolapse, part of the valve slips backward into the left atrium. This occurs when the heart muscle or left ventricle squeezes during a heartbeat.
Mitral valve prolapse: Causes, risk factors
Mitral valve prolapse causes continue to be investigated by medical experts around the world. However, we do know that the most common reason for MVP is stretchy valve leaflets. This is medically referred to as “myxomatous valve disease”. Sometimes, people are born with a risk of developing mitral valve prolapse or the condition can develop due to other health issues, including a connective tissue disease.
When the heart is functioning well, the mitral valve closes completely during contractions, but with MVP, one or both of the mitral valve flaps (leaflets) have extra tissue bulging or prolapsing into the left atrium every time the heart contracts. The prolapse can keep the valve from closing tightly. There are times when blood leaks backward through the valve and this is called mitral valve regurgitation.
Mitral valve prolapse can happen to anyone at any age, but the more serious symptoms of mitral valve prolapse tend to occur in men over the age of 50. You will be at a higher risk for MVP if someone else in your family has suffered from it or if you suffer from any of the following conditions:
- Marfan syndrome
- Ehlers-Danlos syndrome
- Epstein’s anomaly
- Graves’ disease
- Muscular dystrophy
Mitral valve prolapse complications
Mitral valve regurgitation, as described above, is the most common complication associated with MVP. When regurgitation is severe, some people need surgery to repair the valve to prevent problems, such as stroke. There are other potential complications associated with mitral valve prolapse:
Heart rhythm problems. Arrhythmias, or irregular heart rhythms, can occur, although they aren’t normally life-threatening. Data shows that people with severe mitral valve regurgitation or a severe deformity in their valve are at a greater risk of having rhythm problems, which impact blood flow through the heart.
Heart valve infection. An infection can occur in the thin membrane that lines the valves of the heart. The membrane is called endocardium and the infection is known as endocarditis. The risk of an infection tends to be higher in older men.
Symptoms of mitral valve prolapse
The phrase mitral valve prolapse sounds frightening, as if it would be extremely painful, but it is important to understand that it can sound more painful than it actually is for some people. There are those who experience MVP and have no symptoms. These individuals may also never have any health problems due to the condition. Not everyone is lucky though. Other people do experience mitral valve prolapse symptoms that range from slightly bothersome to rather scary.
For instance, some people have chest pain and fear that they are having a heart attack. Mitral valve prolapse does not increase the risk of a heart attack. One thing to consider though is that over several years, moderate to severe mitral regurgitation can weaken the heart muscle. This is known as congestive heart failure. Symptoms of congestive heart failure can include shortness of breath when exerting yourself or swelling in the feet and legs.
Mitral valve prolapse has been linked to other symptoms, including those listed below.
- Anxiety attacks
- Fluttering or rapid heartbeat
- Numbness or tingling in the hands and feet
- Shortness of breath when exercising
Sometimes these symptoms occur together. When this happens, it is referred to as mitral valve prolapse syndrome. Doctors aren’t certain if mitral valve prolapse actually causes these symptoms. Since these signs and symptoms and mitral valve prolapse are common, they could just be occurring together.
How is mitral valve prolapse diagnosed?
In most cases, mitral valve prolapse is diagnosed during a physical exam. Doctors can detect MVP by listening to the heart using a stethoscope. Sometimes they can hear a clicking sound or they hear a heart murmur if blood is leaking backwards through the mitral valve. There are tests that can help doctors confirm a mitral valve prolapse. We outline some of those tests here.
Echocardiogram: This is a non-invasive evaluation of the heart using high-frequency sound waves to create images of the heart and its structures, including the valves and flow of blood.
Chest X-ray: An X-ray can show a picture of the heart, lungs, and blood vessels to give the doctor a better view. It can help determine if the heart is enlarged.
Electrocardiogram: Commonly called an ECG, probes are placed on the chest that can record the electrical impulses that make the heart beat. An ECG can detect irregularities in heart rhythm and structure.
Stress test: During a stress test, a person exercises to increase heart rate. This can tell the doctor if mitral valve regurgitation is limiting a person’s ability to exercise.
Coronary angiogram and cardiac catheterization: While not usually used to diagnose MVP, the condition can be found during cardiac catheterization for another condition. In cases where tests show conflicting results with regards to mitral valve regurgitation, a coronary angiogram can help determine the severity of the problem. A cardiac catheterization may also be performed if a doctor determines that a person needs heart valve surgery.
Treating and preventing mitral valve prolapse
Mitral valve prolapse treatment can vary person to person. In most cases, there is no need for any treatment, just regular check-ups every few years. Some people do have a lot of leaking of blood and have to be monitored more closely. Any complications, such as endocarditis or arrhythmias, can be treated with medications. There was a time when doctors recommended antibiotics prior to dental work or surgery to prevent infections in people who suffered from mitral valve prolapse. However, this is no longer the protocol.
Unfortunately, there are some situations where people require heart surgery to repair or replace the mitral valve. These are usually cases where there is severe backwards blood leakage, which can lead to an enlarged heart and cause heart failure or arrhythmias. Doctors try to repair whenever possible because when successful, such an operation enables the heart muscle to pump stronger than if an artificial valve was implanted. Additionally, this type of repair doesn’t require the use of blood thinners, which have to be administered with artificial valves.
It’s important to keep in mind that the heart muscle gets stronger with exercise just like other muscles in the body do. For example, aerobic exercise can strengthen the heart, so it is recommended for people who suffer from mitral valve prolapse. Walking, swimming, cycling, and light jogging for 30 minutes at a time is also considered safe. If a person with MVP is exercising, feels light-headed or experiences any other symptoms, they should slow down or take a break.
There are cases where mitral valve prolapse can pose significant health problems and valve replacement may have to be considered. While the prospect of valve replacement sounds scary, according to heart disease experts, the majority of patients with mitral valve prolapse don’t seem to have any higher risk of sudden death than the general population.