Mitral Valve Prolapse

The mitral valve is one of the heart's four valves, and it's located between the heart's left upper and lower chambers. This valve has flaps, like tiny doors, that open and close to control blood flow. In mitral valve prolapse, these flaps are loose or floppy. When the heart beats and squeezes (contracts), these flaps bulge into the left upper chamber, a bit like a parachute drooping backward.

Sometimes, this bulging can cause a small amount of blood to leak backward through the valve. This leakage is called mitral valve regurgitation.

Problems with the mitral valve, a heart valve, can cause a leak. This leak, when it happens, can lead to various symptoms.

The symptoms of mitral valve prolapse, a condition where the mitral valve doesn't close completely, can differ greatly from person to person. Some people have no noticeable symptoms at all. Others might experience mild symptoms that start slowly and get worse over time.

Possible symptoms of mitral valve prolapse include:

• Irregular heartbeat: Your heart might beat too fast or skip beats. This is sometimes called an arrhythmia.
• Feeling dizzy or lightheaded: This can happen because your heart isn't pumping blood effectively.
• Shortness of breath: You might have trouble breathing, especially when you're active or lying down. This is because your heart isn't delivering enough oxygen to your body.
• Feeling tired or weak (fatigue): This is common because your heart is working harder than usual to compensate for the leaking valve.

These are just some of the potential symptoms. If you're concerned about your heart health, it's always best to talk to a doctor. They can properly diagnose the cause of any symptoms you're experiencing.

If you're experiencing symptoms that might be related to mitral valve prolapse, schedule a visit with your doctor. Many other health issues can cause similar symptoms, so it's important to get checked out.

If you have sudden or unusual chest pain, or think you might be having a heart attack, go to the emergency room right away. This is a serious medical situation that needs immediate attention.

If you already have a diagnosis of mitral valve prolapse, see your doctor if your symptoms become more noticeable or get worse. Regular check-ups are important for managing this condition.

Understanding mitral valve disease starts with understanding how the heart works.

Your heart has four valves that act like one-way doors, making sure blood flows in the correct direction. These valves have flaps, or leaflets, that open and close with each heartbeat. If a valve doesn't open or close completely, it can disrupt the flow of blood throughout the body.

Mitral valve prolapse happens when one or both of the leaflets in the mitral valve are loose or have extra tissue. This extra tissue or looseness causes the leaflets to bulge or protrude (prolapse) into the left upper heart chamber (left atrium) during each heartbeat.

Think of it like a parachute that bulges backward. This bulging can prevent the valve from closing completely. When blood flows backward through the valve, this is called mitral valve regurgitation. This backward flow of blood can put a strain on the heart and reduce the amount of oxygen-rich blood that gets pumped to the rest of the body.

Mitral valve prolapse is a condition that can affect anyone, regardless of age. While most people with mitral valve prolapse don't experience noticeable problems, serious symptoms are more common in men over 50.

Sometimes, mitral valve prolapse runs in families, meaning it can be passed down through generations. This condition might also be connected to other health issues. These include:

• Ebstein anomaly: A heart condition where a heart valve doesn't develop correctly.
• Ehlers-Danlos syndrome: A group of inherited disorders affecting connective tissues, which support and hold together various parts of the body.
• Graves' disease: An autoimmune disorder affecting the thyroid gland.
• Marfan syndrome: A genetic disorder affecting connective tissues, leading to various body part abnormalities.
• Muscular dystrophy: A group of inherited diseases causing progressive weakness and loss of muscle mass.
• Scoliosis: A sideways curvature of the spine.

These other conditions can sometimes be linked to mitral valve prolapse, meaning they might occur together. It's important to remember that having one of these conditions doesn't automatically mean you'll develop mitral valve prolapse. If you have concerns about your heart health or any of these conditions, it's crucial to talk to a doctor.

Mitral valve prolapse can sometimes lead to problems. Here are two common ones:

1. Leaky mitral valve (mitral valve regurgitation): The flaps of the mitral valve, which control blood flow in the heart, don't close completely. This means blood leaks backward through the valve when it should be closed. This makes the heart work harder. Men are at a slightly higher risk for this problem, and high blood pressure can also increase the chance of a leaky mitral valve.

2. Irregular heartbeat (arrhythmias): If the mitral valve prolapse gets worse and causes a lot of backward blood flow (regurgitation), it can swell the upper left chamber of the heart (the atrium). This swelling can sometimes cause the heart to beat irregularly.

Diagnosing Mitral Valve Prolapse

Doctors typically diagnose mitral valve prolapse by first performing a physical exam. During this exam, they listen to your heart using a stethoscope.

Sometimes, a distinctive clicking sound is heard when a person has mitral valve prolapse. If blood is leaking backward through the valve, a whooshing sound (called a heart murmur) might also be detected.

To confirm the diagnosis and learn more about the condition, several tests may be ordered. These tests help evaluate the health of your heart.

Echocardiogram: This test uses sound waves to create moving pictures of your heart. A standard echocardiogram, sometimes called a transthoracic echocardiogram (TTE), is a common way to diagnose mitral valve prolapse and determine how severe it is.

For a clearer look at the mitral valve, a doctor might order a transesophageal echocardiogram (TEE). In this test, a small device connected to a tube is inserted down your throat into your esophagus (the tube connecting your mouth to your stomach).

Chest X-ray: This X-ray shows the condition of your heart and lungs. It can help determine if your heart is enlarged, which could be a sign of problems.

Electrocardiogram (ECG or EKG): This quick and painless test measures the electrical activity of your heart. An ECG can help detect irregular heartbeats (arrhythmias) that might be linked to mitral valve prolapse.

Exercise or Stress Tests: These tests often involve walking on a treadmill or riding a stationary bike while your heart is monitored with an ECG. These tests show how your heart reacts to physical activity. They can also help reveal if mitral valve prolapse symptoms appear during exercise. If you can't exercise, medication that mimics the effects of exercise might be used instead.

Cardiac Catheterization: This test isn't frequently used to diagnose mitral valve prolapse. However, if other tests haven't provided a clear diagnosis, a cardiac catheterization might be helpful. In this test, a thin tube (catheter) is carefully inserted into an artery in your arm or groin and guided to the heart. Dye is injected through the catheter to make the heart's arteries more visible on X-ray images.

Mitral valve prolapse is a condition where one of the heart's valves doesn't close completely. Most people with mitral valve prolapse, especially those without noticeable symptoms, don't need any treatment. This is because the valve often functions well enough to maintain normal heart function.

If you have a small leak in the mitral valve (called mitral valve regurgitation) and don't feel any problems, your doctor might suggest regular checkups to watch for any changes.

However, if the leak is significant (severe mitral valve regurgitation), even without symptoms, treatment might be necessary. This could involve medication or surgery.

Medications:

Sometimes, medications are needed to address other issues that might arise from mitral valve prolapse. These problems can include irregular heartbeats (arrhythmias), or other complications. Common types of medications include:

• Beta-blockers: These help relax blood vessels and slow the heart rate, which can lower blood pressure.
• Diuretics (water pills): These help your body get rid of excess salt and water through urine, also lowering blood pressure.
• Anti-arrhythmics: These drugs help regulate irregular heartbeats.
• Blood thinners (anticoagulants): If the prolapse causes an irregular heartbeat called atrial fibrillation (a rapid, irregular heartbeat), blood thinners can prevent potentially dangerous blood clots from forming. Atrial fibrillation significantly increases the risk of stroke. If you've had a mitral valve replacement with a mechanical valve, you'll need blood thinners for the rest of your life.
• Antibiotics: Generally, antibiotics aren't needed for mitral valve prolapse. However, if you've had a mitral valve replacement, your doctor might recommend antibiotics before dental work or other procedures to prevent a heart infection called infective endocarditis.

Surgery:

Most people with mitral valve prolapse don't need surgery. But if the prolapse causes a severe leak (regurgitation), surgery might be recommended. Again, this could be necessary even without symptoms.

Surgical options for a faulty mitral valve typically include repair or replacement. Repair is often preferred because it keeps your existing valve.

Repair or replacement can be done through open-heart surgery or a less invasive technique. Minimally invasive surgery uses smaller cuts, often leading to less blood loss, shorter recovery times, and less pain.

During mitral valve repair, the surgeon might trim extra tissue to help the valve flaps close properly. They might also replace the tiny cords (chordae tendineae) that support the valve.

If valve repair isn't possible, the surgeon will replace the damaged valve. A replacement valve can be either a mechanical valve (made of metal) or a biological valve made from animal tissue (like cow, pig, or human heart tissue). In some cases, a procedure called a valve-in-valve procedure might be used to place a new valve inside a damaged biological valve that isn't functioning correctly.