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What is Mitral Valve Prolapse?

Tricia Christensen
Tricia Christensen
Tricia Christensen
Tricia Christensen

When the heart contracts, the mitral valve, located between the left atrium and ventricle, opens to allow the passage of blood into the left ventricle. In mitral valve prolapse, the valve has malformations of the leaflets that open and the strings, or chordae, that support the valve. A small amount of blood leaks backward, called regurgitation, as a result of the leaflets not meeting perfectly as they close.

While once considered a defect, some degree of mitral valve malformation is now thought to be a normal variation. In about 95% of cases, benign mitral valve prolapse never necessitates surgery, though physicians may hear a significant murmur with a stethoscope. Diagnosis of mitral valve prolapse, even when mild, is important. Even those with a very mild form should probably take antibiotics before dental exams and procedures to prevent bacterial endocarditis.

A small amount of blood leaks backward into the heart during a mitral valve prolapse.
A small amount of blood leaks backward into the heart during a mitral valve prolapse.

Mitral valve prolapse does not pose problems for infants, unless it is severe or associated with other congenital heart defects, but it tends to worsen with age. Symptoms of this condition may be recognized during the teenage years, or may not be noticed until a person is well into their second or third decade.

Symptoms include arrhythmia, fatigue, shortness of breath, and chest pain. Symptoms do not necessarily indicate the severity of mitral valve prolapse. In some cases, mild prolapse results in symptoms but does not require treatment. In other situations, prolapse may be significant but not have many symptoms.

A doctor may hear a murmur with a stethoscope, but most patients with mitral valve prolapse never need surgery.
A doctor may hear a murmur with a stethoscope, but most patients with mitral valve prolapse never need surgery.

When treatment for mitral valve prolapse is required, several options are considered, the first being medications to improve heart function and control heart rhythm. If there is blockage in the valve, the minimally invasive balloon valvuloplasty may be attempted to open up the passageway of the valve and prevent blood from backing up in the left atria. Balloon valvuloplasty is not generally successful, as mitral valve prolapse tends to recur.

Shortness of breath is one symptom of mitral valve prolapse.
Shortness of breath is one symptom of mitral valve prolapse.

If possible, a cardiothoracic surgeon will try to repair the valve. He or she may separate the leaflets if necessary, and also shorten the chordae to create a more effective valve. Frequently, though, surgeons elect to replace the valve completely. The new valve may be either a porcine or bovine valve, or often a mechanical valve.

Porcine and bovine valves are not as viable as mechanical valves. They have the advantage of only requiring blood thinners for a few months post-operatively. Mechanical valves require taking blood thinners, like warfarin, for life. This can be particularly difficult for young children, as the levels of warfarin must be consistently monitored.

Mitral valve prolapse usually does not pose any problems for infants unless it is associated with other congenital heart defects.
Mitral valve prolapse usually does not pose any problems for infants unless it is associated with other congenital heart defects.

Mitral valve prolapse has been linked to several causes. Rheumatic fever can damage the mitral valve and surrounding heart tissue. Mitral valve prolapse can be a congenital condition, or it can be caused by bacterial endocarditis. There is some evidence to suggest that congenital mitral valve prolapse may be genetic, as it tends to be present in more than one family member. If you have a family history of mitral valve prolapse, inform your physician, as the problem can be easily diagnosed through echocardiogram.

Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent TheHealthBoard contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

Learn more...
Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent TheHealthBoard contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

Learn more...

Discussion Comments

anon121300

I'm a 26 year old diagnosed with Hypoplastic right heart syndrome and mitral valve prolapse. I've been doing OK for the past 26 years in and out of hospitals and trying to manage pain and confusion on why god would want someone to go through a life such as this.

i also had a nine month old son pass away from hypoplastic left heart too. Someone help with information to my condition.

I'm having sudden symptoms such as cold sweats and nightmares, chest pains and trouble breathing sometimes.

bonxgz

Hi.. can anyone tells me the symptoms of first grade heart murmurs? the doctor said my nephew has it. Is this risky? What shall we do? My nephew is 18 years old now.

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    • A small amount of blood leaks backward into the heart during a mitral valve prolapse.
      By: adimas
      A small amount of blood leaks backward into the heart during a mitral valve prolapse.
    • A doctor may hear a murmur with a stethoscope, but most patients with mitral valve prolapse never need surgery.
      By: pkchai
      A doctor may hear a murmur with a stethoscope, but most patients with mitral valve prolapse never need surgery.
    • Shortness of breath is one symptom of mitral valve prolapse.
      By: nuiiko
      Shortness of breath is one symptom of mitral valve prolapse.
    • Mitral valve prolapse usually does not pose any problems for infants unless it is associated with other congenital heart defects.
      By: Patricia Marks
      Mitral valve prolapse usually does not pose any problems for infants unless it is associated with other congenital heart defects.
    • Surgery may be required to treat mitral valve prolapse.
      By: astoria
      Surgery may be required to treat mitral valve prolapse.
    • Symptoms of mitral valve prolapse may include fatigue.
      By: zonch
      Symptoms of mitral valve prolapse may include fatigue.
    • Cardiologists may recommend antibiotics to people with mitral valve prolapse issues prior to dental exams and procedures.
      By: Alen-D
      Cardiologists may recommend antibiotics to people with mitral valve prolapse issues prior to dental exams and procedures.