Mitral Valve Prolapse
One of the most commonly discovered heart abnormalities is mitral valve prolapse. MVP symptoms are non-specific. Mitral valve prolapse treatment depends on severity of a case, ranging from valve replacement surgery to routine check-ups. More detailed information about this condition you will find below.
Mitral valve prolapse (also known as “click murmur syndrome” and “Barlow’s syndrome”) is the most common heart valve abnormality.
What is Mitral Valve Prolapse?
The mitral valve is a valve that lets blood move from the left atrium to the left ventricle. In mitral valve prolapse, part of the mitral valve slips backward loosely into the chamber called the left atrium. This happens when the main heart muscle, called the left ventricle, squeezes during each heartbeat. Mitral valve prolapse differs from mitral valve stenosis. In mitral valve stenosis, the mitral valve is stiff and constricted.
In mitral valve prolapse, the valve slips backward due to the abnormal size of or damage to the mitral valve tissues. For most people with mitral valve prolapse, the cause is largely unknown.
Mitral valve prolapse can run in families. It can also be caused by conditions in which cartilage is abnormal (connective tissue disease).
In most people, mitral valve prolapse isn’t life-threatening and does not require any treatment or changes in lifestyle. However, for some people with mitral valve prolapse, treatment is required.
Although mitral valve prolapse is usually a lifelong disorder, many people with this condition never display any symptoms. When diagnosed, people may be surprised to learn that they even have a heart condition.
When MVP symptoms and signs do occur, it may be because blood is leaking backward through the valve (regurgitation). Mitral valve prolapse symptoms do vary widely from one person to another. They tend to be mild and develop gradually. Symptoms can include:
- An irregular heartbeat (arrhythmia)
- Dizziness or light-headedness
- Difficulty breathing or shortness of breath, often when lying flat or during physical exertion.
- Chest pain that’s not caused by a heart attack or coronary artery disease
MITRAL VALVE PROLAPSE TREATMENT OPTIONS
Most people with mitral valve prolapse, particularly those without symptoms, don’t need treating.
If you have mitral valve regurgitation but don’t have MVP symptoms, your doctor may suggest monitoring it by scheduling regular follow-up examinations, depending on the severity of your condition.
However, if you have symptoms and if a significant amount of blood is leaking through the mitral valve and depending on the severity of your condition, your doctor may prescribe you medications or recommend you get surgery.
If you develop MVP symptoms, your doctor might prescribe certain medications to treat mitral valve prolapse-related chest pain, heart rhythm abnormalities or other complications. Some of these medications include:
- Beta blockers: These drugs help prevent irregular heartbeats by making your heart beat more slowly and with less force, which helps to reduce your blood pressure. Beta blockers also help blood vessels relax and expand to improve blood flow.
- Diuretics: These are water pills (diuretics) that are used to drain fluid from your lungs.
- Heart Rhythm medications: Your doctor may prescribe medications such as flecainide (Tambocor), procainamide (Procanbid), sotalol (Betapace) or amiodarone (Cordarone, Pacerone) to control your heart rhythm.
- Aspirin: If you have a history of having strokes and have mitral valve prolapse, your doctor might prescribe aspirin to reduce the risk of blood clots.
- Prescription anticoagulants (blood thinners): These medications such as warfarin (Coumadin), heparin and dabigatran (Pradaxa) — prevent your blood from clotting if you have had irregular heart rhythms, such as atrial fibrillation.
If you have atrial fibrillation, a history of heart failure or a history of strokes, your doctor might recommend these drugs. They can however have dangerous side effects and therefore must be taken exactly as prescribed.
SURGICAL MITRAL VALVE PROLAPSE TREATMENT
Though most people with MVP symptoms don’t need surgery, your doctor may suggest surgical mitral vapve prolapse treatment if you are having severe mitral valve regurgitation with or without symptoms. Severe mitral valve regurgitation can eventually cause heart failure, preventing your heart from effectively pumping blood.
If regurgitation is prolonged for too long, your heart may be too weak for surgery to be performed. If your doctor suggests surgery, your doctor may suggest repair or valve replacement surgery. Valve repair and replacement may be performed using open-heart surgery or minimally invasive surgery.
Minimally invasive surgery involves smaller incisions and may have less blood loss and a quicker recovery time overall than open surgery.
- Valve repair: Mitral valve repair is a surgery that preserves your valve. For most people with mitral valve prolapse, this is the preferred surgical treatment for mitral valve correction. Your mitral valve consists of two triangular-shaped flaps of tissue called leaflets. These leaflets connect to the heart muscle through a ring called the annulus. The surgeon can modify the original valve (valvuloplasty) to eliminate any backward blood flow. Surgeons can also repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close properly. Sometimes tightening or replacing the annulus is necessary and this is called an annuloplasty. It is important to ensure that your surgeon is experienced in performing mitral valve repair.
- Valve replacement: Your surgeon may perform a valve replacement if valve repair isn’t an option. In valve replacement surgery, the damaged mitral valve is replaced by an artificial valve. Artificial valves can either be mechanical or tissue valves. Mechanical valves may last a long time. However, if you have a mechanical valve, you must use an anticoagulant medication, such as warfarin (Coumadin), for the rest of your life to prevent blood clots from forming on the valve. If a blood clot forms on the valve and breaks free, it could travel to your brain and cause a stroke. Tissue valves are made from animal tissue such as a pig or cow valve. These kinds of valves are called bioprostheses. They may wear out over time and need replacement. However, they have the advantage of not requiring any long-term anticoagulant medication.
DIAGNOSING MITRAL VALVE PROLAPSE
- History taking and physical exam: Your doctor will ask you questions about your life style, symptoms you are experiencing and whether your family has a history of heart disease. Then he will perform a physical examination, which involves checking you pulse, blood pressure, auscultation and percussion of your heart. A doctor may suspect mitral valve prolapse after listening to someone’s heart with a stethoscope. The abnormal movement of the mitral valve can make a very distinct sound, called a “click.” If mitral regurgitation is also present, a doctor may hear a heart murmur caused by the backward flow of blood.
- Echocardiogram: An echocardiogram is usually done to confirm the diagnosis. An echocardiogram is a noninvasive evaluation of your heart using an ultrasound. This test uses high-frequency sound waves to create images of your heart, including the mitral valve itself, and the flow of blood through it. You may have a transesophageal echocardiogram. This test involves your doctor inserting a flexible tube with a small device (transducer) attached to your throat and down into your esophagus — the tube that connects the back of your mouth to your stomach. Because your esophagus is directly behind your heart, a transesophageal echocardiogram is able to create clear, detailed images of your heart and mitral valve. Doctors may also use this test to examine the mitral valve prior to surgery. During an echocardiogram, doctors perform a Doppler ultrasound to evaluate the blood flow and measure the amount regurgitation (blood leakage). This test helps doctors ascertain the severity of your condition.
- Chest X-ray: A chest X-ray shows a picture of your heart, lungs and blood vessels and can assist your doctor in making a diagnosis. It can also show if your heart is enlarged.
- Electrocardiogram (ECG):This is a noninvasive test that involves a technician placing probes on your chest in order to record the electrical impulses that make your heart beat. An ECG records these electrical signals and can enable your doctor to detect irregularities in your heart’s structure and rhythm, including mitral valve prolapse.
- Stress test: Your doctor may order a stress test to see if mitral valve regurgitation limits your ability to exercise or not. In a stress test, you exercise or take certain medications to make your heart work harder by increasing your heart rate. You may also have a stress test if your doctor is trying to determine if you have another condition such as coronary artery disease.
- Coronary angiogram and cardiac catheterization: A coronary angiogram and cardiac catheterization aren’t usually used to diagnose mitral valve prolapse, however, mitral valve prolapse may be detected during cardiac catheterization for another condition.