Mitral Valve Prolapse (MVP) F.A.Q.

What is mitral valve prolapse?

Mitral valve is one of the four heart valves. This is located between upper (atrium) and lower (ventricle) left chamber of the heart. The job of this valve is to allow only one way flow of blood from upper chamber to the lower one so that blood can subsequently be pumped forward to nourish our body. For this function, it has to open to let the blood flow forward and then close tight to prevent the back flow. In case of mitral valve prolapse, part of mitral valve buckles while closing as shown in the picture below.

Source: http://www.nursing.wright.edu/practice/mvp/default.htm

How common is mitral valve prolapse (MVP)?

By some estimates, mitral valve prolapse may be present in 0.6 to 2.4% of the population. That said, mitral valve prolapse has been over diagnosed in the past. More on that later.

Can mitral valve prolapse (MVP) run in families?

If you have mitral valve prolapse , the chances of your other family members having mitral valve prolapse is high. Some of the patients’ family members may want to get an echocardiogram done if one of their family members is diagnosed to have mitral valve prolapse.

What are the common symptoms of mitral valve prolapse (MVP)?

The mitral valve prolapse is commonly diagnosed by a health provider during heart examination or it may be diagnosed on an echocardiogram.

Some patients with mitral valve prolapse may have chest pain that is not actually due to blockage of the heart arteries. Some may feel fluttering of the heart due to premature heart beats. If the mitral valve prolapse leads to significant leakage of this valve, symptoms of heart failure may develop. These could include shortness of breath, fatigue, swelling of feet etc.

Can mitral valve prolapse (MVP) cause panic attacks?

The diagnosis of mitral valve prolapse has had a somewhat murky past. According to some authorities, MVP may have been over diagnosed on the basis of heart as well as echocardiographic examination. Because of the overdiagnosis, a very high percentage of the population was thought to have mitral valve prolapse in the past. Because of overestimation of  prevalence of mitral valve prolapse in the population, many other common conditions including panic disorder may have been wrongly thought to be associated with it.

To help understand this, let us say I practice in an area where 95% of the population is of Italian descent. Being a cardiologist in this community, most of the patients coming to my hospital with heart attack are likely to be of Italian descent. Because people of Italian descent and heart problem are two common denominators of my practice, I could be tricked into believing that heart problem is predominantly a disease of people of Italian descent.

What are some of the problems a person with mitral valve prolapse (MVP) can have?

Mitral valve prolapse may put some people at a higher risk for infective endocarditis. This is a term commonly used for infection of the heart valves. The prevention of infective endocarditis includes getting antibiotics before procedures like dental cleaning. The best thing is to let your health providers know that you have a heart valve problem before any procedure. That way they can give you antibiotics before a procedure if they deem it necessary.

This mitral valve abnormality can sometime cause leakage of the valve. The leakage can worsen over time and in certain cases the valve may need to be repaired or replaced.

Sudden death in patients with mitral valve prolapse is one of the concerns. While patients with  mitral valve prolapse are at a high risk for heart rhythm problems, sudden death is the least common complication of mitral valve prolapse.

There is no clear cut evidence of association of stroke and mitral valve prolapse.

I am really concerned that I might have mitral valve prolapse (MVP). What should I do?

A health care provider may be able to diagnose this by examining your heart. A simple non-invasive test called echocardiogram can easily diagnose this condition.

Years ago, I was told that I had mitral valve prolapse (MVP). A doctor recently told me that I do not have mitral valve prolapse. How can that be possible?

Rare instances of transient mitral valve prolapse have been reported during acute coronary syndrome. Later is a condition caused by lack of blood supply to the heart. More likely explanation of your situation is the following.

Years ago, we over diagnosed mitral valve prolapse by examination as well as echocardiogram. Over the years, the echo criteria for the diagnosis of mitral valve prolapse have been tightened. So the patients who were diagnosed to have mitral valve prolapse in the past may not meet new criteria for the diagnosis of mitral valve prolapse.

I have mitral valve prolapse (MVP). What could I expect?

Most of the patients with mitral valve prolapse should expect normal life span.

If you have chest pain or palpitations, you may need a group of medicines called beta blockers.

Some patients may need more elaborate management of heart rhythm problems.

You will need to let your health care providers know about the valve condition before any procedure including dental procedures.

In certain cases, echocardiogram may need to be repeated to follow condition of the valve. In some cases, leakage of the mitral valve may become severe enough to require valve repair or replacement.

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