Mitral Valve prolapse

What is mitral valve prolapse?

The heart has 4 chambers. The two smaller chambers on top are called atria while the two larger chambers at the bottom are called ventricles. There is a door present between the left atrium and left ventricle chambers called the mitral valve. Normally this door closes when the larger chamber (ventricle) is pumping blood out of the heart to the body. In mitral valve prolapse, the parts of mitral valve known as cusps are damaged, which results in the bulging of mitral valve into the smaller top chamber (left atrium) whilst the blood is being pumped out of the heart to the body. This results in blood leaking back into the left atrium i.e. mitral regurgitation. Thus, patients with mitral valve prolapse can develop mitral regurgitation.

Causes of this condition?

Mitral valve prolapse commonly occurs in patients with connective tissue disorders, which are rare genetic diseases affecting certain tissues of our body. It can also develop due to chronic valvular damage.

What are the symptoms?

Clinical manifestations of mitral valve prolapse include:

1- Asymptomatic: Majority of the cases have no symptoms clinically.

2- It is often diagnosed after a health care provider hears an abnormal "click" sound in the heart alongside a murmur. A murmur is an abnormal heart sound, which is usually heard as an abnormal "swish" sound with a stethoscope.

3- Chest pain, dizziness, palpitations and loss of consciousness.

4- Patients who have associated severe mitral regurgitation will have symptoms of shortness of breath, fluid collection in the body ( e.g. swelling of legs) and tiredness/fatigue.

5- Patients can also have symptoms of anxiety or panic attacks.

What are the possible complications?

Mitral valve prolapse can result in:

1- Severe mitral regurgitation due to backflow of blood from left lower heart chamber to the top chamber. This might require surgical correction.

2- Increased risk of developing infection of the valve. This is called endocarditis, and is a serious condition requiring prolonged antibiotic treatment.

3- Heart rhythm problems: Patients are at increased risk of developing problems related to electrical activity of the heart.

4- Stroke: Risk of stroke is increased in patients with mitral valve prolapse.

How to diagnose?

Your physician will likely suspect this condition after hearing abnormal heart sounds i.e. a " click" sound is heard alongside a heart murmur. Further workup done to confirm this disease includes:

1- Chest X-ray: It is usually normal, but if there is associated severe mitral regurgitation, it will show fluid in lungs or an enlarged heart.

2- EKG: It is a quick test to check the electrical activity of the heart, it can give information about heart rhythm problems that may have caused this condition.

3- Echocardiography: It is an ultrasound of the heart, and gives information about the functioning of the heart valves. It is the best test to diagnose this condition.

Treatment options?

Mild disease: Patients with no symptoms and minimal amount of mitral regurgitation are usually just monitored by their physicians.

Severe disease: For patients who have severe symptoms, surgical treatment might be required. During surgery, the mitral valve is usually repaired or replaced. In patients who cannot undergo surgery, a clip is placed on the mitral valve to minimize the leakage of blood. This clip is placed through one of the vessels, without the need of surgery.