Mitral valve prolapse is a heart condition where the valve between the left upper chamber (atrium) and left lower chamber (ventricle) does not close as it should, which can allow some blood to leak backward with each heartbeat.
In many cases, mitral valve prolapse does not cause symptoms. When symptoms do occur, they may include palpitations, shortness of breath, chest pain, dizziness, or fatigue.
Mitral valve prolapse is typically diagnosed by a cardiologist using an echocardiogram, often after initial findings on physical exam. Most cases require only periodic monitoring, but medications may be prescribed if symptoms or complications develop.
Mitral valve prolapse symptoms
The main symptoms of mitral valve prolapse are:
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Palpitations or a sensation of an irregular heartbeat
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Unusual tiredness or fatigue
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Shortness of breath during physical activity or when lying down
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Dizziness, vertigo, or fainting
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Episodes of anxiety or panic attacks
These symptoms can vary in intensity depending on the degree of valve damage and whether there is any blood leakage.
However, in most cases, this condition does not cause symptoms, and many people have it without knowing. When symptoms do appear, they are usually mild and develop gradually.
Confirming a diagnosis
Mitral valve prolapse is diagnosed by a cardiologist through a physical exam and listening to the heart with a stethoscope.
In some cases, the doctor may hear a characteristic sound called a “mid-systolic click.” If there is blood leakage, the doctor may also hear a heart murmur that can be more noticeable in certain positions, such as when standing or leaning forward.
The main test used to confirm the diagnosis is an echocardiogram, which allows the doctor to see how the mitral valve moves. According to the American Heart Association, this test may be recommended when a heart murmur suggests mitral valve prolapse, as it can evaluate the valve and measure how much blood may be leaking backward.
In some cases, the doctor may also order other tests, such as a transesophageal or three-dimensional echocardiogram, electrocardiogram (ECG), Holter monitor, cardiac MRI, or chest X-ray.
Possible causes
The causes of mitral valve prolapse vary and are usually related to changes in the structure of the valve or hereditary factors.
In some cases, the valve weakens over time due to natural wear and tear of the tissue. This can cause the valve leaflets to stretch or become thinner, leading to improper closure.
Mitral valve prolapse can also run in families and may be caused by inherited changes in genes involved in heart development and function.
Mitral prolapse can also occur together with connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, in which the body’s tissues are more fragile.
Is mitral valve prolapse dangerous?
In most cases, mitral valve prolapse does not cause symptoms or significant changes. According to the American Heart Association, this condition is usually harmless, although treatment may be needed in some situations.
However, mitral valve prolapse can become serious if it is severe or causes severe mitral regurgitation, which is leakage through the valve.
In these situations, people may need treatment with medication or surgery to repair or replace the valve.
Treatment options
Treatment for mitral valve prolapse is usually not needed when there are no symptoms. In this case, regular medical follow-up is recommended.
When symptoms are present, treatment prescribed by the cardiologist may include:
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Antiarrhythmics to control irregular heartbeats
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Beta-blockers for palpitations or chest pain
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Diuretics to reduce fluid buildup in the lungs
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Anticoagulants to prevent blood clots
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Surgery to repair or replace the valve when there is significant blood leakage into the left atrium
In more complex cases with high-risk arrhythmias, advanced treatments, such as catheter ablation or implantation of an implantable cardioverter-defibrillator (ICD), may be considered.
In some cases, it may also be necessary to limit participation in competitive sports.