Mitral Valve Prolapse: Information on Causes, Diagnosis & Treatments

Mitral Vale Bulge Into Atrium Mitral Valve Prolapse (MBP) develops when the mitral valve leaflets prolapse (bulge) into the heart’s left atrium (left upper chamber) when the heart contracts. Mitral valve prolapse is also referred to as floppy valve syndrome, Barlow syndrome, and click-murmur syndrome.

The condition can be serious because it can cause blood to leak backward into the left upper chamber causing mitral valve regurgitation. However, mitral valve prolapse isn’t always a life-threatening condition where many individuals live with the prolapse without making changes in their lifestyle choices or receiving treatment. That said, serious conditions require an effective treatment to stop the prolapse and becoming worse.

Who Is at Risk for Mitral Valve Prolapse?

While any individual can develop mitral valve prolapse, those greatest at risk have:

  • Graves’ disease

  • A personal or family history of rheumatic fever

  • some forms of muscle or dystrophy

  • Skeletal problems including scoliosis

  • Connective tissue disorder including Ehlers-Danlos syndrome and Marfan syndrome

The condition affects individuals of both sexes at all ages. However, elderly men and women have an increased potential risk of developing the disease compared to younger people.

Doctors, scientists, and researchers have yet to determine the exact cause of MVP. It is thought that some individuals are born with the condition because it tends to run in families (genetic predisposition). The condition occurs because the valves are unable to make a tight seal during heart contractions because:

  • The flap of the valve has become too thick or large

  • The valve opening has stretched

  • The flap of the valve has become floppy where the supporting “strings” has stretched too far on the flap’s tissue or the valve has bulged or flopped backward into the left upper chamber.

Some individuals with mitral valve prolapse have more than one abnormality causing the condition.

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Mitral Valve Prolapse Symptoms

Many individuals who have mitral valve prolapse never experienced any symptoms or have major backflow of the mitral valve. That said, the most common mitral valve prolapse symptoms include:

  • Chest discomfort

  • Migraine headache

  • Anxiety, dizziness, and/or tiredness (fatigue)

  • Coughing

  • Shortness of breath

  • Intense palpitations where the heart will flutter, skip a beat, or beat too fast or too hard

The symptoms experienced by different patients vary greatly. Additionally, symptoms in the initial stages of a developing prolapse might be mild but will worsen as the condition worsens, leading to serious complications.

Mitral Valve Prolapse Complications

Complications associated with mitral valve prolapse are extremely rare. However, when they do present themselves, the complications are often caused by the blood back flowing through the mitral valve. These conditions tend to be common in individuals with high blood pressure, especially men. Often, this complication requires valve surgery to repair the problem. This is because the backflow in the mitral valve can cause the flow of blood to travel from the left ventricle into the left atrium or eventually back up into the lungs and causes shortness of breath.

Arrhythmia

If the complication of the mitral valve prolapse causes the heart to beat too slow, too fast or irregularly, the organ is often unable to pump sufficient amounts of blood throughout the body. This can cause considerable damage to organs including the heart and brain. A mitral valve prolapse complication can also lead to atrial fibrillation (AF) arrhythmias where the walls of the atria shudder instead of maintaining a normal beat. Because of that, the atria lacks the ability to pump blood normally into the ventricles.

While atrial fibrillation can be inconvenient, it is rarely life-threatening unless a blood clot forms in the atria. This can happen because the blood can pool in the atria instead of pumping through the ventricles and out to the body. If a clot develops and breaks off and could travel to the bloodstream it can eventually reach the brain, resulting in a stroke.

Mitral Valve Infections

If the mitral valve flap becomes deformed, it can attract bacteria that is floating in the bloodstream that attaches to the valve. This can cause serious infections including infective endocarditis that produces chills, fever, headaches, and body aches. While a mitral valve flap infection is rare, it can be a serious condition when it does occur. To minimize the potential of developing a mitral valve infection, it is important to routinely brush and floss the teeth and take steps to avoid tooth decay and gum infections.

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Diagnosing Mitral Valve Prolapse

Doctors diagnose mitral valve prolapse during routine physical examinations. While the doctor is examining the patient, they will lift into the heart using a stethoscope and might detect a clicking sound as stretched valve flaps shut. That said, abnormal heart sounds can be caused by a temporary problem. Because of that, the doctor will likely perform other procedures and tests to accurately diagnose a mitral valve prolapse. Some of these include:

  • Echocardiogram – An echo (echocardiography) is highly effective at diagnosing a mitral valve prolapse using sound waves to generate a moving image of the heart muscle. The test can identify the shape and size of the heart and how well the valves and chambers are working. In addition, the test produces a moving image to show if the muscle is contracting normally, has been injured, or producing insufficient blood flow.

An echocardiogram can also produce an image to show the prolapse of the valve where blood his back flowing through a leak. The procedure can be performed with or without a stress test. It is often used to detect coronary heart disease.

  • Doppler Ultrasound – The ultrasound is used in conjunction with the echocardiography test to show the direction and speed of blood flow as it passes through the mitral valve.

  • Chest X-Ray – An x-ray can detect fluid in the lungs and help determine if the heart has become enlarged.

  • Electrocardiogram (EKG) – This simple test records the electrical activity of the heart muscle and indicates how fast the heart is beating, and detect and unsteady or irregular heart rhythm. Some doctors used the test to record the timing of the heart’s electrical signals.

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Mitral Valve Prolapse Treatments

Most cases a mitral valve prolapse do not require treatment because there are no complications or symptoms associated with the condition. Even individuals who display symptoms might not require treatment if the amount of blood back flowing through the valve is occurring at an insignificant rate. That said, individuals who have complications with their mitral valve prolapse might require medications, surgical procedures, or both.

The goal of the doctor in treating a mitral valve prolapse includes correcting the underlying problem, relieving symptoms, and preventing serious complications including arrhythmia and infective endocarditis. Because of that, the doctor might prescribe or recommend:

  • Blood Thinning Drugs to reduce the potential risk of developing blood clots

  • Diuretics to remove excessive fluid and sodium in the lungs and body

  • Drugs including procainamide and flecainide to regulate heart rhythms

  • Digoxin that strengthens heartbeats

  • Vasodilators to widen blood vessels and reduce the workload of the heart

  • Surgical Procedures including valve repair or valve replacement

  • Transcatheter Valve Therapy

Some patients must antibiotics before having any dental procedures to minimize the potential of causing an infection of the mitral valve.

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Sources:

http://www.mayoclinic.org/diseases-conditions/mitral-valve-prolapse/home/ovc-20307842

http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Problem-Mitral-Valve-Prolapse_UCM_450441_Article.jsp#.WTnDHGjyuHs

https://my.clevelandclinic.org/health/articles/mitral-valve-prolapse

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