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Mitral valve prolapse
Alternative namesBarlow's syndrome; Floppy mitral valve; Myxomatous mitral valve; Billowing mitral valve; Systolic click-murmur syndrome; Prolapsing mitral leaflet syndrome
DefinitionMitral valve prolapse is a disorder in which the heart's mitral valve -- which separates the left upper chamber (atrium) from the left lower chamber (ventricle) -- billows out and does not close properly.
Causes, incidence, and risk factors
Mitral valve prolapse can be caused by a variety of mechanisms. In most cases, it is harmless and does not cause symptoms or need to be treated. In a small number of cases, it can cause severe mitral regurgitation (leakage of blood back through the valve) and needs to be treated with surgery.
Some forms of mitral valve prolapse seem to be hereditary. Mitral valve prolapse has been associated with Marfan's syndrome (a disorder present from birth), Graves' disease , and other disorders.
Many people with mitral valve prolapse are thin women who may have minor chest wall deformities, scoliosis , or other disorders. There may also be an atrial septal defect (a hole in the wall that separates the left and right upper heart chambers) high in the wall of the heart (called an ostium secundum defect).
Signs and tests
The doctor may feel a thrill (vibration) over the heart. Using a stethoscope, the doctor may hear a distinctive murmur or other abnormal sounds. (The murmur is described as a mid-systolic click and is sometimes followed by a late systolic murmur. This means a click sound is heard midway in the "beating" part of the heartbeat cycle, followed by a murmur near the end of this time.) The murmur is worse when standing. Blood pressure is usually normal.
Mitral valve prolapse and associated regurgitation may show on:
In most cases there are no or few symptoms and treatment is not necessary. There are no restrictions on activity or diet.
Hospitalization may be required for diagnosis or treatment of severe symptoms. Surgical repair or valve replacement may be required if severe mitral regurgitation develops, or if symptoms worsen.
Propranolol may be given for palpitations or chest pain . Anticoagulants (blood thinners) may be used to prevent clot formation if atrial fibrillation is present; atrial fibrillation increases the chances of clot formation).
Expectations (prognosis)The outcome varies depending on underlying conditions. Mitral valve prolapse is usually benign and without symptoms. When symptomatic , it is controllable with medications and may be improved with surgery. Some arrhythmias associated with this condition can be fatal, however.
Calling your health care provider
Call your health care provider if symptoms suggest mitral valve prolapse.
PreventionThis condition itself may not be preventable, but some complications are. Discuss any history of heart valve disease or congenital heart disease before any treatment by the health care provider or dentist.
Any dental work, including cleaning, and any invasive procedure can introduce bacteria into the bloodstream. This bacteria can infect a damaged mitral valve, causing endocarditis . Giving antibiotics to prevent infection (rather than waiting for infection to develop) is recommended for individuals with mitral valve prolapse when a significant regurgitation is documented. Other physicians recommend antibiotics when moderate to severe mitral valve prolapse has been confirmed and a "click" is present at auscultation.
Update Date: 9/23/2002A.D.A.M. editorial. Previous review: Seth Keller, M.D., Division of Cardiology, Yale New Haven Medical Center, New Haven, CT. Review provided by VeriMed Healthcare Network (5/25/2002).
Last updated: Tue, 06 Jan 2009 00:20:03 GMT