Mitral Valve Prolapse: Is It Dangerous?

Medically reviewed by Richard N. Fogoros, MD

Mitral valve prolapse occurs when the mitral valve between the heart's left atrium and left
ventricle doesn’t close properly. In some cases, failure of the valves to close tightly allows blood to flow backward through the heart, known as mitral regurgitation.

Most cases of mitral valve prolapse aren’t serious and don’t cause symptoms. However, when mitral regurgitation becomes severe, it raises the risk of more serious complications and may require treatment with medications or surgery to repair or replace the valve.

This article will examine how mitral valve prolapse affects the body, along with symptoms, causes, diagnosis, and treatment.

How Mitral Valve Prolapse Affects the Body

Heart valves are made up of flaps that open and close with every heartbeat, working to direct blood
flow through the heart or out of the heart to the lungs and body.

The mitral valve has two flaps. It directs blood flow from the heart’s left atrium to its left ventricle. Normally, two small tendons connect the flaps to the heart, forming a tight closure that prevents blood from flowing backward.

Mitral valve prolapse occurs when one or both of the mitral valve flaps enlarge and prolapse (bulge) into the left atrium when the heart contracts. This prolapse can prevent the valve from sealing tightly, leading to blood flowing backward into the atrium, known as regurgitation. Most people who have mitral valve prolapse do not have mitral regurgitation.

Mitral Valve Prolapse Symptoms

Most people with mitral valve prolapse do not experience any symptoms or problems. If there is mitral regurgitation, it can worsen over time and lead to infection. Also, with mitral regurgitation, the increasing amount of blood in the left-side chambers of the heart can cause those chambers to enlarge.

Symptoms of mitral valve prolapse may include:

• Fast or irregular heartbeats (palpitations)

• Chest pain, unlike typical angina

• Anxiety

• Hyperventilation or shortness of breath

• Dizziness

• Exercise intolerance

• Weakness

What Causes Mitral Valve Prolapse?

Not a lot is known about the causes of mitral valve prolapse, although a genetic risk for the condition can be inherited. The most common cause is having mitral valve flaps that are abnormally stretchy (myxomatous valve disease). Certain connective tissue diseases, such as Marfan syndrome, can also cause mitral valve prolapse.

Who’s More Likely to Get Mitral Valve Prolapse?

Mitral valve prolapse is seen in about 2 out of 100 people, making it a common heart condition. Most people who have mitral valve prolapse were born with the condition. Mitral valve prolapse can run in families, and those with a family history are at higher risk of getting the condition.

Risks are increased with these conditions:

• Connective tissue disorders: These include the inherited genetic conditions Marfan syndrome and Ehlers-Danlos syndrome.

• Rheumatic fever: This condition can occur after a group A Streptococcus infection (such as strep throat) that isn't adequately treated. It can damage the heart valves.

• Graves' disease: This is an autoimmune condition in which the immune system produces an antibody that causes the overproduction of thyroid hormones, which affect the heart.

• Scoliosis: With scoliosis, the spine is curved to the side. Other skeletal problems are also a risk factor.

• Muscular dystrophy: This group of disorders causes progressive muscle weakness. In some forms, the risk of mitral valve prolapse is raised.

• Older age: Risk increases as you age.

How Mitral Valve Prolapse Is Diagnosed

Because most people with mitral valve prolapse don’t have symptoms, the condition is often first discovered when a click or murmur from regurgitation is heard through a stethoscope during a routine physical exam.

If a murmur is detected, your healthcare provider might order a diagnostic electrocardiogram (EKG) to look for irregularity in heartbeats. They might request an echocardiogram that creates images of the heart using ultrasound and is the best way to detect mitral valve prolapse.

If symptoms are severe, other diagnostic tests such as a cardiac stress test, cardiac catheterization, or cardiac magnetic resonance imaging (MRI of the heart) might be necessary.

Risk of Heart Infection

Mitral valve prolapse raises the risk of endocarditis, an infection when bacteria enter the bloodstream and infect the inner lining of the heart chambers and valves. Because tooth decay and gum infection raise the risk of endocarditis, it’s important to practice good dental hygiene if you have mitral valve prolapse.

How Mitral Valve Prolapse Is Treated

Mitral valve prolapse without symptoms typically doesn't require treatment and instead is
regularly monitored for any changes.

If symptoms such as chest pain or heart palpitations are present, treatment can include medications such as beta-blockers. In cases where mitral valve prolapse is causing atrial fibrillation, blood thinners might be prescribed.

If severe mitral regurgitation is present, surgical interventions of either mitral valve replacement or mitral valve repair are usually recommended before congestive heart failure develops.

Mitral valve repair is usually done through open heart surgery. However, sometimes robotically assisted mitral valve repair is performed (generally in young, active individuals). A newer procedure called a mitral valve clip is available to individuals who are not good candidates for open heart surgery.

Valve repair is usually recommended over valve replacement because it preserves heart tissue. In more serious cases, the valve may need to be replaced using a human, animal, or manufactured mechanical valve.

How Do You Know If You Need Treatment for Mitral Valve Prolapse?

Most people with mitral valve prolapse don’t require treatment. You may need treatment if you have symptoms that worsen, you develop an irregular heartbeat, mitral regurgitation becomes severe, or your heart becomes enlarged.

If an enlarged atrium results in atrial fibrillation, the risk of blood clots is raised, which can lead to heart attack or stroke. An increased risk of dangerous heart rhythms is also seen in a rare variant of MVP called malignant mitral valve prolapse.

An estimated 10% to 15% of people with mitral valve prolapse need mitral valve repair or replacement surgery. Some research has shown that people with mitral regurgitation are at higher risk of heart failure and death and that more people would benefit from surgical treatment than currently have surgery for the condition.

Regular Follow-Ups for Mitral Valve Prolapse

If you have mitral valve prolapse, it’s important to see your healthcare provider regularly to monitor your condition and learn to prevent complications based on your risk. You also should always take any medications as prescribed.

Can Mitral Valve Prolapse Be Prevented?

Most people with mitral valve prolapse are born with the condition. In general, you can lower your risk for heart valve diseases by:

• Living a healthy lifestyle, including eating a heart-healthy diet and exercising

• Not smoking

• Practicing good dental and skin hygiene to prevent endocarditis, which can damage heart valves
  

How Long Can You Live With Mitral Valve Prolapse?

Mitral valve prolapse doesn’t shorten life expectancy. Most people with the condition do not experience any effects. Leading a healthy lifestyle is important in managing the condition and keeping it from getting worse.

Possible Lifestyle Changes

If you have mitral valve prolapse, even without symptoms, it’s important to practice healthy behaviors to prevent the condition from worsening. That includes:

• Avoiding smoking

• Maintaining a healthy weight

• Eating a healthful diet

• Exercising

• Ongoing follow-up care with your healthcare providers

• Practice good dental hygiene to reduce the risk of endocarditis

When to Seek Emergency Care

Call 911 or get to an emergency room if you experience chest pain, heart palpitations, dizziness, or shortness of breath that are severe or different from what you've experienced in the past.

Summary

Mitral valve prolapse occurs when the heart's mitral valve flaps don't close properly. The condition is usually harmless and doesn't cause symptoms. In some cases, failure of the valves to close tightly can lead to mitral regurgitation. If the valve leak is severe, surgery to repair or replace the damaged valve may be necessary.

If you have mitral valve prolapse, it's important to live a healthy lifestyle and be regularly monitored by your healthcare providers.

Read the original article on Verywell Health.