Cochin Cardiac Club

Health Blog by Dr.Uday Nair



Mitral valve prolapse is a heart problem in which the valve that separates the upper and lower chambers of the left side of the heart does not close properly It can be caused by many different things. In most cases, it is harmless and patients usually do not know they have the problem. As much as 10% of the population has some minor, insignificant form of mitral valve prolapse, but it does not generally affect their lifestyle
In a small number of cases, the prolapse can cause blood to leak backwards. This is called mitral regurgitation.
Mitral valves that are structurally abnormal can raise the risk for bacterial infection

A normal mitral valve consists of two thin leaflets, located between the left atrium and the left ventricle of the heart. Mitral valve leaflets, shaped like parachutes, are attached to the inner wall of the left ventricle by a series of strings called "chordae." When the ventricles contract, the mitral valve leaflets close snugly and prevent the backflow of blood from the left ventricle into the left atrium. When the ventricles relax, the valves open to allow oxygenated blood from the lungs to fill the left ventricle.

The mitral valve prolapse (MVP) syndrome has a strong hereditary tendency, although the exact cause is unknown. Affected family members are often tall, thin, with long arms and fingers, and straight backs. It is seen most commonly in women from 20 to 40 years old, but also occurs in men.


Many patients with mitral valve prolapse do not have symptoms. The group of symptoms found in patients with mitral valve prolapse is called "mitral valve prolapse syndrome" and includes:
  • Sensation of feeling the heart beat (palpitations)
  • Chest pain (not caused by coronary artery disease or a heart attack)
  • Difficulty breathing after activity
  • Fatigue
  • Cough
  • Shortness of breath when lying flat
Note: There may be no symptoms, or symptoms may develop slowly.


Signs and tests;

The doctor will perform a physical exam and use a stethoscope to listen to your heart and lungs. The doctor may feel a thrill (vibration) over the heart, and hear a heart murmur ("midsystolic click"). The murmur gets louder when you stand up.
Blood pressure is usually normal.
The following tests may be used to diagnose mitral valve prolapse or a leaky mitral valve:
  • Echocardiogram
  • Color-flow Doppler examination
  • Cardiac catheterization
  • Chest x-ray
  • ECG (may show arrhythmias such as atrial fibrillation)
  • Holter Moniter
  • Stress Test
  • Chest MRI
  • CT scan of the chest 


Most of the time, there are no (or few) symptoms, and treatment is not needed.
If you have severe mitral valve prolapse, you may need to stay in the hospital. You may need surgery to repair or replace the valve if you have severe mitral regurgitation or your symptoms get worse. Mitral valve replacement may be needed if:
  • You have symptoms
  • The left ventricle of the heart is enlarged
  • Heart function gets worse (depressed ejection fraction)

To help prevent a heart valve infection, a person may need preventive antibiotics before certain dental or surgical procedures if  he or she has a murmur of mitral insufficiency
Other drugs that may be prescribed when mitral regurgitation or other heart problems are also present:
  • Anti-arrhythmic drugs help control irregular heartbeats.
  • Water pills (diuretics) help remove excess fluid in the lungs.
  • Propranolol is given for palpitations or chest pain.
  • Blood thinners (anticoagulants) help prevent blood clots in people who also have atrial fibrillation.


  • Endocarditis -- valve infection
  • Severe leaky mitral valve (regurgitation)
  • Stroke
  • Clots to other areas
  • Irregular heartbeat (arrhythmias), including atrial fibrillation


You can't usually prevent mitral valve prolapse, but you can prevent certain complications. Tell your doctor, including your dentist, if you have a history of heart disease or heart valve problems

Follow up;

A person with mitral valve prolapse should see the doctor for a follow-up exam every 1-2 years, including a clinical evaluation and possibly an ECHO test to assess whether blood leakage is worsening.

Please Note;

Call your doctor if you have:
  • Chest discomfort, palpitations, or fainting spells that get worse
  • Long-term illnesses with fevers

In the end Cochin Cardiac Club likes to add Mitral valve prolapse is usually a harmless disorder that does not lead to a heart attack and does not prevent a person from having a normal, active life. The condition does trigger some possible complications(mentioned above), but overall risk for them is very low.

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