Mitral valve prolapse: What you need to know

There are several valves in the heart, which manage the flow of blood between the hearts chambers. The mitral valve is on the left side of the heart.

Mitral valve prolapse occurs when the mitral valve of the heart doesn't work properly. Rather than closing tightly, the flaps of the valve billow into the left atrium of the heart.

The condition is also known as Barlow's syndrome or floppy valve syndrome. Most of the time, this condition causes few, if any, symptoms or complications.

However, mitral valve prolapse may worsen over time. When it does, it can put those with the condition at higher risk for serious heart problems, including infections, life-threatening arrhythmias, and heart failure. As a result, mitral valve prolapse should be monitored by a doctor.

Contents of this article:

1. What is a mitral valve prolapse?
2. Causes
3. Symptoms
4. Diagnosis and when to see a doctor
5. Treatment
6. Outlook

What is a mitral valve prolapse?

The mitral valve is one several valves in the heart that control blood flow between the heart's chambers.

It is located in the heart between two chambers of the heart known as the left ventricle and left atrium. This valve controls blood flow between those two chambers of the heart.

When the mitral valve works correctly, it closes completely when the left ventricle contracts. This prevents blood from backing up into upper left chamber (the left atrium) of the heart.

In people with a mitral valve prolapse, the mitral valve does not work properly due to any number of abnormalities. This may cause blood to back up from the left ventricle into the left atrium.

The amount of blood that backs up into the left atrium varies from person to person. In rare cases, a significant amount of blood can back into the left atrium, causing problems.

Causes

Mitral valve prolapse is caused by abnormalities of the mitral valve. Common abnormalities that cause mitral valve prolapse include the following:

• The flaps of the mitral valve may be too large.
• The mitral valve opening may have stretched or not close entirely.
• The flaps of the valve may be too loose, causing them to push back into the atrium of the heart.

Doctors are not sure what causes these abnormalities exactly. However, there may be a genetic factor since many people that have a mitral valve prolapse are born with it and it tends to run in families.

Symptoms

Some of the symptoms of a mitral valve prolapse can include heart

palpitations, shortness of breath, tiredness, and chest pains not related

 to other heart conditions.

Many people with a mitral valve prolapse never have any symptoms and are surprised to learn that they have a heart condition. However, some people do experience symptoms that develop and worsen over time.

Symptoms of a mitral vary widely from person to person. Symptoms of mitral valve prolapse can include the following:

• palpitations or the feeling of the heart skipping a beat or beating too hard
• racing heart
• irregular heartbeat
• tiredness
• dizziness or lightheadedness
• shortness of breath
• cough
• anxiety
• migraines
• chest pain and discomfort not related to a heart attack or another heart condition

Diagnosis and when to see a doctor

Anyone with any of the symptoms of a mitral valve prolapse should make an appointment with their doctor.

Many other conditions can cause similar symptoms as mitral valve prolapse. Anyone having severe chest pain should seek emergency care to rule out a heart attack.

Most people discover that they have a mitral valve prolapse during a stethoscope exam in a routine doctor's visit. The doctor may detect a heart murmur with a clicking sound.

After detecting the sound, a doctor will likely send a person for tests to confirm diagnosis and severity of the condition. These tests may include:

• an ultrasound of the heart known as an echocardiogram
• chest X-rays
• an exercise stress test
• an electrocardiogram (EKG), a test that records the heart's electrical impulses

Treatment

Often, people with a mitral prolapse do not need treatment. However, a doctor may treat the condition if a person with mitral valve prolapse has symptoms or a significant amount of blood backing up into their left atrium.

In serious cases, treatment may involve surgery to repair the valve,

or replace it with an artificial mitral valve.

There are several treatment options available depending on the severity of the prolapse and symptoms. Treatments include the following options:

• mindful management
• medication
• surgery

For most people, mitral valve prolapse can be treated through mindful management. With this approach, a person with mitral valve prolapse visits their doctor regularly for check-ups and reports any new symptoms that would suggest the problem is getting worse.

If a person has a more severe case of mitral valve prolapse that causes symptoms, a doctor may prescribe medications to help manage the condition.

For people that only experience chest discomfort or palpitations with minimal backflow, a doctor may prescribe drugs called beta-blockers.

For more significant symptoms or backflow, a doctor may prescribe a combination of medications, including the following:

• blood thinners to reduce risk of blood clots
• vasodilators to widen blood vessels
• diuretics to remove excess sodium and fluid
• medications to strengthen the heartbeat or regulate the heart's rhythm

In very rare cases, a doctor may recommend surgery to treat very abnormal or severe cases of mitral valve prolapse.

For a doctor to recommend surgery, the person with the mitral valve prolapse will often experience a high amount of blood back up into the atrium. This can cause severe symptoms or lead to other more serious complications.

Surgery may be performed as open heart surgery or done using less invasive techniques. The options for surgery include several choices:

• mitral valve repair to tighten the flaps of the valve and stop backward blood flow
• valve replacement to replace valves that cannot be repaired with prosthetic valves

Outlook

In the vast majority of cases, mitral valve prolapse is not serious. Many people may have the condition and experience no symptoms at all.

However, the condition may worsen over time and cause symptoms to develop when there were none. In rare cases, complications can occur and may include the following:

• heart failure
• arrhythmias
• infection of the inner tissues of the heart

Complications are rare and most people with mitral valve prolapse can leave normal, healthy lives.