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Mitral Valve Prolapse

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Mitral valve prolapse (MVP) is a common heart condition in which the mitral valve does not close properly. More than 10 percent of Americans are diagnosed with MVP, which is also known as click-murmur syndrome, Barlow's syndrome, balloon mitral valve and floppy valve syndrome.

Mitral valve prolapse may not cause symptoms in all patients. This condition is most often found during a routine medical checkup.

What Is Mitral Valve Prolapse?

The mitral valve is located on the left side of the heart between the top chamber—the left atrium—and the lower chamber—the left ventricle. The mitral valve regulates the flow of blood from the left atrium to the left ventricle. When the left ventricle beats, or contracts, the mitral valve closes and prevents blood from leaking back into the left atrium. The two flaps of the valve are attached to supporting muscles by string-like structures. These strings allow the flaps to close evenly.

In mitral valve prolapse, the mitral valve does not close properly, which sometimes allows blood to leak backward through the valve. This is called mitral valve regurgitation. In mild cases of MVP, the degree of regurgitation may be mild or even nonexistent. However, if the valve proplapse is more severe, the amount of leaking (or the degree of regurgitation) may also be severe.

The treatment depends on the severity. If mild, no specific treatment is necessary. Blood pressure should be controlled and the valve should be monitored for worsening proplase. In severe cases, however, mitral valve repair may be required.

The symptoms of MVP are usually similar to those of other causes of mitral valve regurgitation, depending on severity of the regurgitation. In addition, some patients with MVP will have irregular heart rhythms that cause palpitations, or in worse cases, may even cause fainting or passing out. Less commonly, MVP may be associated with chest pain, however, this is not the type of chest pain that leads to heart attacks.

What Causes Mitral Valve Prolapse?

In some people who have mitral valve prolapse, one or both mitral valve flaps is enlarged with extra tissue. The flaps bulge (prolapse) like balloons into the left atrium each time the heart contracts. The valves are unable to close smoothly or evenly when the heart beats, allowing blood to leak back into the atrium.

The cause of MVP is unknown, but the condition often runs in families.

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Diagnosis of Mitral Valve Prolapse

Mitral valve prolapse is often discovered when a physician listens to the heart with a stethoscope and hears the backflow of blood as a murmur; sometimes a clicking sound is heard before the murmur.

Tests physicians use to diagnose mitral valve prolapse include:

Electrocardiogram (EKG/ECG) – A test that records the electrical activity of the heart.

Echocardiogram (also called echo) – This test uses sound waves to assess the function and structure of the heart muscle and valves.

Exercise stress test – A test performed on a treadmill or stationary bicycle to measure heart, lung and muscle function during physical activity. You are attached to an electrocardiogram (EKG/ECG) to record electrical activity of the heart.

Cardiac catheterization – A procedure to check for problems in coronary arteries. A long, thin tube (catheter) is inserted into an artery or vein in the groin, arm or neck, then threaded to the heart. The physician injects a contrast solution into the artery and takes X-rays to check for blockage and other abnormalities.

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Treatment of Mitral Valve Prolapse

Mitral valve prolapse is often mild and does not require treatment. When a more serious case does occur, a physician may recommend treatment including:

Medications

Beta blockers or other medicines can be used to control fast or irregular heart rhythms. Some patients may need treatment with an blood thinning medication, such as aspirin or warfarin sodium (Coumadin®), usually because of associated atrial fibrillation.

Surgery

Mitral valve repair or mitral valve replacement surgery may be necessary for severe mitral regurgitation or damage.

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Ohio State Medical Center Physicians Who Treat This Condition

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