Mitral valve prolapse: Symptoms and more

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While mitral valve prolapse can remain asymptomatic, some individuals may gradually develop mild symptoms. Doctors primarily attribute these symptoms to the valve prolapsing — bulging — and allowing regurgitant blood flow into the atrium, which means the blood is flowing back into the atrium.

The severity of the prolapse typically determines the extent of a person’s symptoms, which may include:

• a racing or irregular heartbeat
• dizziness
• shortness of breath during exercise or when lying down
• fatigue or extreme tiredness
• chest pain

What is mitral valve prolapse?

The mitral valve sits between the heart’s left atrium and left ventricle. It typically ensures unidirectional blood flow during the heart’s pumping cycle. However, in the case of mitral valve prolapse, structural abnormalities or alterations in the valve’s leaflets or flaps may lead to improper functioning.

Enlarged or stretched leaflets can bulge into the left atrium as the heart contracts with each heartbeat. This allows blood to flow backward through the valve back into the left atrium. Doctors refer to this as mitral valve regurgitation.

Learn more about mitral valve prolapse.

Individuals experiencing any symptoms of mitral valve prolapse should seek medical attention. A doctor can conduct a comprehensive evaluation, including a detailed medical history review and a physical examination.

A person experiencing a sensation of pressure, fullness, or squeezing in the chest, with shortness of breath, cold sweats, and nausea or vomiting should call 911 or seek emergency medical attention. These symptoms can indicate a heart attack, which is a life threatening condition that requires immediate intervention.

Abnormalities of the mitral valve cause mitral valve prolapse. In this condition, the flaps or leaflets of the mitral valve may be longer than typical or excessively loose. As a result, they can protrude back into the atrium. The mitral valve’s opening can also stretch, meaning it can no longer fully close.

Doctors are unsure of the specific reasons why mitral valve prolapse may occur in some individuals, but they associate it with genetic factors. The condition often runs in families, suggesting a hereditary component.

Moreover, there are notable connections between mitral valve prolapse and various connective tissue disorders, including Marfan syndrome and Ehler-Danlos syndrome.

The diagnosis of mitral valve prolapse involves a comprehensive evaluation, which typically includes:

• a detailed medical history review
• a physical examination to look for characteristic heart sounds, such as a systolic click and murmur
• echocardiography — ultrasound of the heart — to visualize the mitral valve and assess its structure and function
• electrocardiography (ECG or EKG) to monitor the heart’s electrical activity

If the mitral valve appears abnormal, the doctor may suggest a TEE, or transesophageal echocardiogram. This is an ultrasound done through the patient’s throat.

Due to the location of the mitral valve — at the back of the heart — it can be difficult to see the mitral valve while scanning through the chest. A doctor can sedate the person and then complete the TEE to evaluate the mitral valve further, if necessary.

An accurate diagnosis is crucial to determine the severity of the prolapse and rule out any other conditions that could be causing the symptoms.

The approach to treatment for mitral valve prolapse depends on the symptoms’ severity and the presence of complications.

Treatment options may include medications to manage symptoms, such as beta-blockers, or surgery for people with more severe cases. Surgeons may opt for open-heart surgery or minimally invasive techniques using robotic-assisted surgery to repair or replace the abnormal mitral valve.

Surgeons usually prefer to repair the valve whenever possible, as these procedures are less likely to damage the heart muscle or trigger an infection.

The choice of treatment considers each person’s specific needs. Doctors will consider the person’s age, health, and severity of their symptoms before recommending surgery.

Many people with mitral valve prolapse have no complications. However, the condition can lead to:

• regurgitation of blood backward through the mitral valve
• infections of the heart or infective endocarditis
• arrhythmias
• heart failure
• stroke
• death

People may not typically be able to prevent mitral valve prolapse, especially if the condition is genetic. That said, individuals with the condition can prevent complications by:

• Practicing good dental hygiene: Brushing and flossing removes bacteria from the teeth and keeps them out of the bloodstream. Reduced bacterial numbers mitigate the risk of a heart infection.
• Attending regular checkups: People should see a healthcare professional regularly tomonitor the progression of their condition and check for complications.
• Following doctor’s instructions: Individuals must take prescribed medications according to a doctor’s instructions. They may also require antibiotics before dental work or surgery to reduce infection risk.
• Choosing heart-healthy habits: A heart-healthy lifestyle of regular exercise, a balanced diet, and stress management can help minimize complications.

Learn more about improving heart health.

The outlook for mitral valve prolapse is usually good. Often, the condition is harmless and causes no symptoms. If a person has symptoms, doctors can control them with medication or surgery.

In some people, the condition is more serious and can be life threatening. The primary factors determining this outlook are the volume of blood leaking backward through the mitral valve and how efficiently the heart pumps blood, known as the ejection fraction.

Mitral valve prolapse is a cardiac condition characterized by the improper closure of the mitral valve. It can lead to various symptoms, such as palpitations and chest pain, and lead to more severe complications. However, for most people, it is a benign condition, causing no symptoms.

If a person has mitral valve prolapse symptoms, doctors may recommend medications or surgery to repair or replace the abnormal valve.