Mitral Valve Prolapse
The Heart and Valves
The heart is a
hollow, muscular organ that continuously pumps
blood throughout the body. It is divided into
four chambers, two upper (the atria) and two
lower (the ventricles). The right and left sides
are separated by a wall called the septum.
Valves permit blood to flow through the heart,
to the lungs, and out to the body through the
aorta. The tricuspid, pulmonic, mitral, and
aortic valves act like one-way doors that keep
the blood flowing in a forward motion. With each
heartbeat, the valves open (allowing blood to
flow into the next chamber or out of the heart)
or close (preventing blood from flowing
backward).
Mitral Valve Prolapse
The mitral
valve is located between the upper and lower
chambers on the left side of the heart (the left
atrium and the left ventricle). In mitral valve
prolapse, a part of the valve billows backward
into the left atrium as it closes. Therefore, it
may not close smoothly or evenly. If it does not
close completely, blood from the left ventricle
may flow backward into the left atrium. A
clicking sound may be heard through a
stethoscope as the valve closes, sometimes
followed by a murmur if blood is leaking
backward through the valve (regurgitation).
Either or both sounds may be heard, or the
syndrome may be silent. Mitral valve prolapse is
also known as click-murmur syndrome, Barlow's
syndrome, straight back syndrome, click chick,
ballooning mitral valve, and floppy
mitral valve syndrome.
Mitral valve prolapse appears to result from a
type of degeneration of the valve support
structure that causes it to stretch and fold
upon itself. The degenerative process is usually
slow. This problem occurs mostly in the mitral
valve. Its cause is unknown. More women (6%)
than men have mitral valve prolapse, and it may
run in families.
Symptoms. Most people with
mitral valve prolapse have no symptoms. The most
common complaint is sharp, stabbing chest pain
that lasts for a few minutes or hours or even a
few days; its cause in unknown. Palpitations (a
feeling that the heart is beating rapidly or
irregularly) are also often reported. Shortness
of breath, dizziness, fatigue, skipped
heartbeats, nervousness, panic, and anxiety may
also be seen. Complications such as severe
leakage, mini-strokes, or valve rupture are
extremely rare.
Diagnosis. Using a stethoscope,
the doctor will listen for the characteristic
click and murmur that accompanies each
heartbeat. An echocardiogram - a painless
test that uses high-frequency sound waves to
show what the heart valves look like - is
commonly used to diagnose mitral valve prolapse.
An electrocardiogram may be taken to
evaluate the heart rate (fast or slow), rhythm
(regular or irregular), and size of the heart
chambers. A 24-hour electrocardiogram, called
Holter monitoring, may also be required. How
the heart responds to exercise may be evaluated
by a stress test, in which an electrocardiogram
is taken while the patient walks or jogs on a
treadmill.
Treatment. Most people do not
require any treatment for mitral valve prolapse.
If the symptoms seem to be related to stress,
the patient may be instructed with an exercise
program or taught relaxation techniques.
Controlling stress and tension, and not getting
too tired, may help.
Most palpitations are harmless and do not
require treatment.Avoiding caffeine (especially
coffee, tea, colas, chocolate, tobacco, and cold
remedies) and alcohol may reduce these
symptoms.Palpitations and chest pains may be the
result of dehydration (not enough fluid in the
body). Drink adequate amounts of water, at least
eight cups per day, depending on activity
levels.
When symptoms are alarming or dangerous (which
is rare), medications such as a beta blocker
should be prescribed for chest pain or irregular
heart rhythms. Serious arrhythmias may be
treated with antiarrhythmic drugs.
Because their risk of infection is increased,
patients who have a murmur caused by a leaking
mitral valve are often instructed to take
antibiotics before having dental work, an
invasive procedure, or surgery.
Conclusion. Mitral valve
prolapse is seldom serious. While the symptoms
may sometimes be disturbing, they can often be
controlled by regular exercise, simple
relaxation techniques, or medication.
Understanding mitral valve prolapse may make it
easier to live with the symptoms.
