Mitral Valve Prolapse: Symptoms, Causes, & Treatment

What is Mitral Valve Prolapse?

Mitral valve prolapse is a disorder of the heart, in which the valve between the left atrium and left ventricle of your heart do not close properly. The upper left chamber is called atrium and the lower left chamber is called ventricle. Your mitral valve consists of two triangular-shaped flaps of tissue called leaflets. The leaflets of the mitral valve connect to the heart muscle through a ring called the annulus. If you have mitral valve prolapse, the leaflets of your mitral valve bulge back into the atrium or upward, when the heart contracts. Sometimes, this leads to leakage of blood into atrium. This is called mitral valve regurgitation, where the oxygenated and deoxygenated bloods get mixed before circulation to the body.

Usually, mitral valve prolapse might not require treatments or changes in lifestyle, if only a small amount of blood gets leaked into the atrium. It might not always be life threatening. However, some people might need treatment.

Symptoms

In most cases, mitral valve prolapse is a lifelong disorder and might not display symptoms. When symptoms occur, it might be owing to mitral valve regurgitation, or blood leaking backward. The signs may vary and develop over a long period of time. They could be:

Dizziness and lightheadedness
Arrhythmia or irregular rhythm of the heart
Shortness of breath, during physical activities or when lying flat
Angina or chest pain, that is not due to other heart diseases
Fatigue

Causes

Mitral valve prolapse is relatively rare and is known to occur only in two percent of the population. Generally, the cause of mitral valve prolapse is the valve leaflets being abnormally stretchy. This is known as myxomatous valve disease. This could either be a genetic disorder or could be caused due to other health problems, like diseases in the connective tissues of the body.

Risks

You are likely to contact Mitral valve prolapse if you are a man above fifty years of age, with conditions such as:

Marfan syndrome
Ehlers-Danlos syndrome
Ebstein's anomaly
Muscular dystrophy
Graves' disease
Scoliosis

Prevention

Prevention is not possible for Mitral valve prolapse, although it can be treated if diagnosed on time.

Physical examination

While listening to your heartbeats using a stethoscope, your doctor might hear clicking sounds, which are common in this condition. The doctor might also notice murmur in the heart if the blood is leaking backward.
Echocardiogram

Using ultrasound testing, this test creates images of your heart and the structures of the heart, with the mitral valve and the flow of blood through it.
Transesophageal echocardiogram

A transducer or a slender tube with a small device is inserted into the esophagus, which is directly behind your heart. It can therefore, create clear and detailed images of the heart and mitral valve using ultrasound waves.
Doppler ultrasound

During this test, ultrasound is used to evaluate the amount of blood leakage. This is used to assess the severity of the situation.
X-Ray

This is used for a pictorial representation of your heart, lungs and blood vessels.
Electrocardiogram

Using electrodes, this method records the electrical impulses of your heart. The findings may be used to discover irregularities in the rhythm and structure of your heart.
Stress test

You might be asked to walk on a treadmill, during which the condition of your heart will be monitored. This test will be used to analyze if your condition limits your physical activities in any form.
Angiogram and catheterization

These techniques involve production of images using colored dyes. Although not generally used to diagnose mitral valve prolapse, it might be found out using these tools. It could be used to determine the severity of the situation, if other tests produce conflicting results. It is important to look out for signs of coronary artery disease before deciding upon the necessity of a surgical procedure.

How is it treated?

If you do not have symptoms, you might not require treatment. In case you have mitral valve regurgitation but without symptoms, your doctor at Medanta might advise you to have regular follow-up examinations for monitoring your condition. However, ..

Pharmacotherapy
Medication to resolve certain issues related to mitral valve prolapse, like chest pain, arrhythmia etc. may be administered. Some of these are:
- Beta blockers – Beta blockers are used to prevent irregularity in heartbeats and excessive pressure on the heart, thereby reducing blood pressure
- Heart rhythm medication – To control the rhythm of your heartbeats
- Diuretics – These water pills are used to drain water from lungs
- Aspirin – This is used to decrease the risk of blood clots
- Anticoagulants – These pills are used to thin the blood and prevent clotting of blood
Surgical therapy
If the regurgitation of the prolapse is severe, your cardiologist might recommend a surgery. This is because the regurgitation might eventually lead to heart failure, because of decreased efficiency of pumping. Using surgery, your mitral valve may be repaired or replaced. It might be done using open-heart surgery or methods that involve smaller incisions and lesser loss of blood, along with quicker recovery time. Using a technique called valvuloplasty, the surgeon modifies the original valve to eliminate backward blood flow. Using another technique called annuloplasty, the annulus is tightened or repaired. If repairing the existing valve is not an option, it would be replaced by a prosthetic or artificial valve, that is mechanical or tissue based. Although mechanical valves last a long time, you would have to take blood thinning medication along with it, to prevent formation of clots. Tissue valves are of animal origin, usually pig or cow. These might get worn out and might need replacement. However in this method, anticoagulative medication is not required.