Mitral Valve Prolapse

What is mitral valve prolapse?

The mitral valve allows blood to flow from the left atrium to the left ventricle in the heart. Mitral valve prolapse (MVP) is the bulging (prolapse) of one or both of the mitral valve flaps (leaflets) into the left atrium when the heart contracts. When the flaps don't close properly, blood leaks backward. This is called regurgitation. Regurgitation may cause a heart murmur, an abnormal sound in the heart caused by turbulent blood flow. When regurgitation is present, it’s generally mild. But it can get worse 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 back-flow 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 doesn't damage the heart. However, regular checkups with a doctor are advised.

What causes Mitral Valve Prolapse?

The cause of MVP is unknown, but most cases are thought to be inherited. There are 2 forms of MVP: primary and secondary.

Primary MVP

Primary MVP means the mitral valve is abnormal because of one or more of these changes:

  • One or both of the flaps are too large and thick
  • The flap surfaces are scarred
  • The tendon cords are thinner or longer than they should be
  • There are fibrin deposits on the flaps
Primary MVP is most often an isolated disease. But is can be linked to other valve or skeletal problems. Some rare instances of MVP are hereditary.

Secondary MVP

In secondary MVP, another disease is linked to MVP. Often the valve flaps are not thickened. Prolapse occurs for other reasons. The prolapse may be from:

  • Damage caused by decreased blood flow from coronary artery disease to the muscles attached to the tendon cords
  • Functional changes in the heart muscle
  • Damage to valve structures caused by heart attack, rheumatic heart disease, valve infection, or hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is when the left ventricle of the heart is larger than normal.
  • Damage caused by a connective tissue disorder such as Marfan syndrome

What are the symptoms of Mitral Valve Prolapse?

MVP may not cause any symptoms. Symptoms may vary depending on the degree of prolapse present. The presence of symptoms doesn't necessarily match the severity of MVP.

These are the most common symptoms of MVP:

  • Fast or irregular heartbeats (palpitations). This may be the result of irregular heartbeats or just the sensation of the valve closing when the heart rhythm is normal.
  • Chest pain. Chest pain linked to MVP is different from chest pain associated with coronary artery disease. Usually the chest pain is not like classic angina, such as pain with exertion, but it can happen often, can be very uncomfortable, and can affect your quality of life.
  • Anxiety
  • Hyperventilation
  • Exercise intolerance
  • Dizziness
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 healthcare provider for a diagnosis.

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