Mitral valve prolapse

Mitral valve prolapse is a condition in which the mitral valve doesn't close correctly. This valve sits between the two left chambers of the heart—the left atrium and left ventricle. Instead of snapping shut when the left ventricle contracts, the valve bulges backward (prolapses). This lets blood leak backward from the left ventricle to the left atrium, making the heart work harder.

This usually doesn't cause any problems. In some people, though, the leak worsens to create a significant backflow of blood into the left atrium. This is called mitral regurgitation. People with severe mitral regurgitation can develop symptoms such as shortness of breath, fatigue and leg swelling. Heart surgery may be needed to repair the damaged valve.

Mitral valve prolapse affects up to 5% of people in the United States. It is a lifelong condition that usually does not cause any symptoms or affect lifestyle or life expectancy.

Symptoms

Most people with mitral valve prolapse don't know it—they feel fine and it doesn't cause any symptoms. It is usually discovered when a doctor hears a certain clicking sound, with or without a heart murmur, when listening to the heart with a stethoscope during a routine physical examination.

Mitral valve prolapse was once blamed for symptoms such as chest pains, palpitations, and lightheadedness. Individuals with mitral valve prolapse can have those symptoms, but mitral valve prolapse is usually not the cause.

When mitral valve prolapse leads to mitral regurgitation, it may cause

• fatigue
• shortness of breath
• leg swelling
• and other symptoms of heart failure

Diagnosing mitral valve prolapse

Mitral valve prolapse is often diagnosed during a routine physical examination when your doctor hears a sound called a systolic click when listening to your heart with a stethoscope. The systolic click is an abnormal heart sound caused by the malfunction of the mitral valve. Some people also have a heart murmur, an abnormal heart sound caused by turbulent blood flow.

An echocardiogram can help determine the severity of the prolapse. This is a painless test that uses sound waves to map out your heart structure.

If you have symptoms such as chest pain, dizziness or palpitations, further tests may be needed to determine the cause.

Treating mitral valve prolapse

As long as mitral valve prolapse is not causing any symptoms, no treatment is needed.

Doctors once recommended that people with mitral valve prolapse take antibiotics before having dental work and other procedures. New guidelines from the American Heart Association say that antibiotics are no longer recommended for people with mitral valve prolapse.

Individuals who have mitral valve prolapse and chest pain or palpitations can take a beta-blocker, such as propranolol (Inderal), metoprolol (Lopressor) or atenolol (Tenormin), to treat symptoms.

If mitral valve prolapse turns into severe mitral regurgitation, the defective mitral valve may need to be repaired or replaced. This can be done with open-heart surgery. A newer option is to repair the faulty valve from inside the heart using a small tube called a catheter equipped with a device to anchor the mitral valve's leaflets in place.