Mitral Valve Prolapse

The mitral valve, which got its name from its resemblance to a bishop's mitre, is the heart valve that prevents the backflow of blood from the left ventricle into the left atrium. It is composed of two leaflets (one anterior, one posterior) that close when the left ventricle contracts.

What are the symptoms?

Some patients with mitral valve prolapse experience heart palpitations, atrial fibrillation, or fainting, though the prevalence of these symptoms does not differ significantly from the general population. Between 11 and 15% of patients experience moderate chest pain and shortness of breath. These symptoms are most likely not caused directly by the prolapsing mitral valve, but rather by the mitral regurgitation that often results from prolapse. In addition, the American Heart Association has linked anxiety and panic attack disorders to mitral valve prolapse.

What are the risk factors?

For unknown reasons, mitral valve prolapse patients tend to have a low body mass index (BMI) and are typically leaner than individuals without it. It is a frequent occurrence in individuals with the Marfan syndrome. Other risk factors include chest wall deformities and Graves' disease. Most patients only need reassurance. Those with mitral valve prolapse and symptoms of palpitations and chest pain may often benefit from beta-blockers (e.g., propranolol). Patients with prior stroke and/or atrial fibrillation may require blood thinners, such as aspirin or warfarin. However, although beta blockers are commonly prescribed, they may be of limited benefit. Unless otherwise contraindicated, many people with mitral valve prolapse benefit from non-drug interventions, such as increased fluid and sodium intake, avoiding adrenalin-like substances found in many over-the-counter medications, avoiding caffeine, and getting regular cardiovascular exercise.

How is it treated?

Mitral valve prolapse associated with severe mitral regurgitation can be treated with repair or surgical replacement of the mitral valve. Repair of the mitral valve is always preferable to replacement and should be performed by surgeons that are skilled in the procedure. Dr. Messner can discuss the appropriate course of treatment for you.