Patient education: Mitral valve prolapse (The Basics)

What is mitral valve prolapse? — 

This is a condition in which 1 of the valves in the heart (figure 1), called the mitral valve, does not close normally (figure 2). The mitral valve is between the left atrium and left ventricle. It is made up of 2 flaps. In mitral valve prolapse, 1 or both flaps billow or bulge into the left atrium.

When the heart valves work normally, they keep blood flowing in only 1 direction. The mitral valve normally keeps blood flowing from the left atrium to the left ventricle (figure 1).

When the mitral valve flaps do not close correctly, blood can leak backward in the wrong direction. When blood leaks backward from the left ventricle to the left atrium, it is called "mitral regurgitation." Some patients with mitral valve prolapse also have mitral regurgitation.

What causes mitral valve prolapse? — 

It can happen on its own or it can happen with other medical conditions. For example, "connective tissue diseases," which are diseases that affect certain tissues in the body, can cause mitral valve prolapse.

What are the symptoms of mitral valve prolapse? — 

Many people have no symptoms. They might find out they have mitral valve prolapse after their doctor or nurse listens to their heart during a routine exam. When the doctor or nurse listens to the heartbeat with a stethoscope, they might hear:

●A change in the heart sounds – This can sound like a "click."

●A heart murmur – This is an extra sound that often sounds like a "whoosh" or "swish."

Mitral valve prolapse can be mild or severe. It sometimes also leads to serious problems. These can include:

●Mitral regurgitation – This usually causes no symptoms until it is severe. Severe mitral regurgitation can cause trouble breathing and tiredness.

●Infective endocarditis – This is when a heart valve gets infected. It usually causes fever, chills, and tiredness.

●Heart rhythm problems – Sometimes, this makes people feel like their heart is beating fast or hard. Rarely, a heart rhythm problem can cause sudden cardiac arrest, which is when the heart suddenly stops beating.

Is there a test for mitral valve prolapse? — 

Yes. Doctors usually do an echocardiogram ("echo") to check for mitral valve prolapse. This is an imaging test that uses sound waves to create pictures of the heart as it beats. It shows the size of the heart chambers, how well the heart is pumping, and how well the heart valves are working (figure 3).

How is mitral valve prolapse treated? — 

Treatment depends on how severe the mitral valve prolapse is and whether it is causing problems. If you have mitral valve prolapse and mild mitral regurgitation, you might not need any treatment. But your doctor will tell you when to schedule follow-up appointments so they can check if your condition gets worse.

For those who need treatment, options might include:

●Surgery or a procedure to repair or replace the mitral valve – This can be done as open heart surgery or by putting a thin tube called a "catheter" into a vein to get to the heart.

●Medicines to treat heart rhythm problems

●Medicines to help prevent blood clots – These might be used if people also have a heart rhythm problem called "atrial fibrillation."

●Medicines to reduce the amount of work the heart has to do

Do I need to take antibiotics before I go to the dentist? — 

Probably not. In the past, doctors recommended people with mitral valve prolapse take antibiotics before going to the dentist or having certain medical or dental procedures. But now, most people with mitral valve prolapse do not need antibiotics in these situations. Now, doctors only recommend this for people with certain heart conditions. For example, people with a prosthetic (replacement) valve need to take antibiotics before some procedures. The same is true for people who had a valve infection in the past.

What if I want to get pregnant? — 

Talk to your doctor before you start trying. They will discuss any problems that might happen during your pregnancy. They might also need to change your medicines to ones that are safer to take during pregnancy.

More on this topic

Patient education: Mitral regurgitation (The Basics)
Patient education: Heart murmurs (The Basics)
Patient education: Endocarditis (The Basics)
Patient education: Sudden cardiac arrest (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: Prosthetic valves (The Basics)

Patient education: Mitral regurgitation (Beyond the Basics)
Patient education: Antibiotics to prevent heart valve infections (Beyond the Basics)