Mitral Valve Prolapse

What Is Mitral Valve Prolapse?

The mitral valve is located between the heart’s left ventricle (upper left chamber) and left atrium (lower left chamber). The valve opens and closes to allow blood flow in both chambers. When healthy, it also prevents blood from flowing backward.

Mitral valve prolapse (MVP) occurs when one or both of the mitral valve flaps (leaflets) bulge into the left atrium as the heart contracts. The condition is sometimes also called click-murmur syndrome, Barlow’s syndrome, balloon mitral valve and floppy valve syndrome.

In most cases, MVP doesn’t need to be treated. It’s rarely a serious condition and doesn't damage the heart. However, MVP may cause mitral valve regurgitation, a condition in which blood leaks and flows backward through the mitral valve. People with moderate to severe mitral regurgitation may need their mitral valve repaired or replaced with open surgery, minimally invasive surgery, or a transcatheter procedure to reduce the risk of serious complications such as congestive heart failure, atrial fibrillation and stroke.

Mitral Valve Prolapse Causes

The cause of MVP is unknown, but genetics is thought to play a role. There are two types of MVP:

• Primary: In primary mitral valve prolapse, thickening occurs in one or both mitral valve flaps. There may also be scarring on the flap surface and thinning of the tissues that support the valve. Primary MVP is often seen in people with Marfan syndrome or other inherited connective tissue diseases, but it occurs most frequently in people with no other form of heart disease.
• Secondary: In secondary mitral valve prolapse, another disease or condition is linked to MVP. Often the valve flaps are not thickened in secondary MVP. The damage to the valve and supporting structures may be caused by coronary artery disease, heart attack, rheumatic heart disease, valve infection or hypertrophic cardiomyopathy.

Who Is at Risk for Mitral Valve Prolapse?

MVP can affect people of all ages and is a cause of primary mitral valve regurgitation. Risk factors for MVP include:

• Graves disease.
• Connective tissue disorders affecting heart and skeletal tissue such as Marfan syndrome.
• Scoliosis and other skeletal problems.
• Some types of muscular dystrophy.

Mitral Valve Symptoms

Mitral valve prolapse doesn’t always cause symptoms. When symptoms do occur, they vary depending on the severity of the condition and may include:

• Fast or irregular heartbeats (palpitations).
• Chest pain.
• Anxiety.
• Hyperventilation.
• Dizziness.
• Exercise intolerance.
• Abnormal heart sounds (murmurs or clicks) that can be heard through a stethoscope.

If MVP causes moderate to severe mitral valve regurgitation, a person may experience symptoms such as weakness, fatigue, dizziness and shortness of breath.

How Is Mitral Valve Prolapse Diagnosed?

Your doctor may notice a heart murmur or click during a routine physical exam. The murmur is caused by blood leaking back into the left atrium. The click is caused by the snapping action of the stretched flaps as they tighten during contraction. To confirm diagnosis of MVP, your doctor may order certain tests, including:

• Electrocardiogram (ECG): Small sensors are taped to your skin to record the strength and timing of the heart’s electrical activity. An ECG can show abnormal rhythms and can sometimes detect heart muscle damage.
• Chest X-ray: An X-ray can reveal lung problems and detect an enlarged heart.
• Transthoracic echocardiogram (echo or TTE): This test uses sound waves (ultrasound, sonogram) to create images of the heart's chambers and valves. A TTE is the most useful test for diagnosing MVP.

For more severe symptoms, other tests may be ordered.

Mitral Valve Prolapse Treatment

MVP usually doesn’t require treatment unless it causes significant mitral valve regurgitation. Regular checkups with your healthcare provider are advised. If MVP causes another heart condition such as mitral valve regurgitation, treatment is important.

Why Choose UH Harrington Heart & Vascular Institute?

UH Harrington Heart & Vascular Institute serves Northeast Ohio communities and beyond with award-winning heart and vascular expertise. We are recognized as a best-in-class choice by patients and healthcare providers. Our heart and vascular specialists consistently earn high ratings on HCAHPS patient experience surveys and provider review sites like Healthgrades and RateMDs. In addition to clinical practice, our physicians are advancing the field of cardiovascular medicine and surgery by leading nationally funded clinical trials.