Definition

Mitral valve prolapse (MVP) is a common, usually benign heart disorder. The mitral valve controls blood flow between the upper and lower chambers on the left side of the heart. Normally, blood should only flow from the upper chamber into the lower chamber. In MVP, the valve flaps don’t work properly. Part of the valve balloons into the atrium, which may be associated with blood flowing in the wrong direction or leaking back into the lower chamber.

Causes

In most cases, the cause of MVP is unknown. In some cases, it appears to be an inherited genetic condition.

Risk Factors

MVP is more common in women, and most often appears between the ages of 14 and 30 years old. Other factors that may increase your chance of MVP include:

• Family history of mitral valve prolapse
• Scoliosis
• Thin chest diameter
• Low body weight
• Low blood pressure
• Chest wall deformities
• Marfan syndrome
• Grave’s disease
• Ehlers-Danlos syndrome
• Ebstein’s anomaly

Symptoms

People with mitral valve prolapse often do not have symptoms. If symptoms do occur, they may include one or more of the following:

• Fatigue
• Chest pain
• Panic attacks or anxiety
• Irregular heartbeat
• Shortness of breath
• Lightheadedness

Diagnosis

Mitral valve prolapse can be heard through a stethoscope. A small blood leakage will sound like a murmur. When the mitral valve balloons backward, it may produce a clicking sound. Both murmurs and clicks are signs of MVP. An echocardiogram can confirm the diagnosis. You may also be asked to wear a Holter monitor for a day or two to record the electrical activity of your heart.

Treatment

In most cases, no treatment is necessary. Although no longer routinely recommended, you may need to take antibiotics prior to some dental and medical procedures. This is to prevent heart infections. Ask your doctor if you will need to take antibiotics.

If symptoms include chest pain, anxiety, or panic attacks, a beta-blocker medication can be prescribed. Ask your doctor whether you may continue to participate in your usual physical activities.

In very rare cases, the blood leakage may become severe. In these few cases, the mitral valve may need to be surgically repaired or replaced.

Prevention

There are no current guidelines for preventing MVP of unknown or genetic origin. However, you may be able to prevent symptoms through certain lifestyle changes:

• Avoid excess caffeine and alcohol, and any drugs that speed up your heart rate.
• Exercise regularly and eat a heart-healthy diet.

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

The College of Family Physicians of Canada http://www.cfpc.ca

Mitral valve prolapse. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated August 20, 2013. Accessed August 20, 2014.

Premedication (antibiotics). American Dental Association’s Mouth Healthy website. Available at:
http://www.mouthhealthy.org/en/az-topics/p/Premedication-or-Antibiotics.aspx
Accessed August 20, 2014.

Shipton B and Wahba H. Valvular heart disease: review and update. Am Fam Physician. 2001;63:2201-2208.