Before jumping into what mitral valve prolapse (MVP) is, it is better to create an idea about where mitral valve is present and what are its functions.
The mitral valve is present in the heart. The heart consists of 4 chambers – right and left auricle on top and right and left ventricle at the bottom. The heart functions to collect the deoxygenated blood from all over the body into the right atrium and then it is pumped into the right ventricle from there the blood travels to the lungs where it picks up oxygen and then travels back to the heart’s left atrium, and then to the left ventricle and finally to all parts of the body. The blood usually flows from the upper chambers to the lower chambers. Both the upper and lower chambers of the heart consist of valve that prevents the backward flow of blood. One such valve that controls the flow of blood is mitral valve (MV).
The mitral valve is present in between the left atrium and left ventricle. The mitral valve allows the blood flow from the left atrium to the left ventricle but not backwards. The mitral valve has two flaps or cups therefore it is also called as bicuspid valve. Similarly the right chambers consist of tricuspid valve, which functions the same as the mitral valve.
TMVP is a congenital condition, where people are born with it. Mitral valve diease is a condition where the mitral valve does not function properly. This is also called as Barlow’s syndrome. In MVP, when the left ventricle contracts one or both the flaps of the MV prolapse bulges or swings back into the left atrium, the flaps of MV are floppy and do not close tightly resulting in backward flow of blood. The backward flow of blood is called as mitral regurgitation. MVP doesn’t cause backward flow in every patient; in fact most patients with MVP do not show any sign of complications. Even with MVP in many, the MV can form a sufficient tight seal that prevents backward flow of blood. Symptoms and complications are seen in patients who experience backward blood flow.
MVP can get worse overtime and can result in heart size change, increased pressure on the left atrium, and MV infection. MVP affects about 5-15% of the population.
The exact cause of MVP is still under wraps. People who are suffering from MVP are usually born with it. MVP is also seen running in families. MVP is closely associated with Marfan syndrome (connective tissue disorder) and is more common in people who are born with Marfan syndrome. MVP is also associated with other conditions like - Ehlers-Danlos syndrome (group of disease like loose joints, hyperelastic skin, easily bruised, and damaged blood vessels), Osteogenesis imperfect (brittle bone disease), Polycystic kidney disease (multiple cyst/tumor on the kidney).
MVP is a lifelong disorder but it usually does not show any signs or symptoms. Few symptoms in people who show them include
MVP can be diagnosed at any age. Symptoms that the patient is experiencing will be considered but it does not provide any conclusive diagnosis. A simple stethoscope is used to listen to the clicking sound and heart murmur sound.
A test done called echocardiogram uses high frequency sound waves to create an image of the heart structure including the MV. The flow of blood and the amount of leakage can also be measured. Electrocardiogram (ECG) is a non-invasive technique that records the electrical impulse of the heart and helps to detect any abnormality in the heart beat, heart structure, and also MVP.
A chest X-ray shows the picture of heart, lungs, and blood vessels, any abnormality can be easily diagnosed. (Magnetic resonance imaging MRI) uses strong magnetic waves to capture a picture of the chest region. This shows the structure of heart and the blood flow. Cross-sections of the chest and upper abdominal region are produced using X-rays.
A Treadmill stress test may also be done. The persons heart beat and heart function is recorded when he/she is exercising. This test is done to see whether MV regurgitation occurs and does it limit the ability to exercise. It is done if the person complains of chest pain and to know whether chest pain is due to MVP or coronary heart disease.
Cardiac catheterization may be done if the doctor suspects that the MVP is too severe. This procedure involves injecting dye into the heart’s blood vessels and then taking a series of X-ray images. The X-ray offers a detailed structure of heart arteries and pressure in the heart chamber. It also helps the doctor to determine whether the patient requires a coronary artery bypass along with mitral valve surgery.
Many people with MVP do not require any treatment. But of course people who have complications due to MVP requires treatment, which will be decided by the doctor. Treatment depends on the severity of the disease and the complications it is causing. Treatment options for MVP include medication or surgery.
Medication to treat MVP-related chest pain, irregular heartbeat, and other complications are prescribed. Beta-blockers are prescribed to correct irregular heartbeat, high blood pressure, and improper blood flow. Aspirin is given to reduce the risk of blood clot in people with high risk for stroke. In patients with a previous history of heart failure or stroke, doctor may prescribe anti-coagulants or blood thinner to avoid blood clotting.
In case of severe MVP and severe regurgitation, doctor will recommend surgery. Surgery includes either MV repair or MV replacement.
Although MVP does not cause any serious complications it should be continuously monitored by the doctor. Any symptoms that seem to disturb the normal functioning of a person should be immediately consulted with doctor. Finally, MVP should not and usually does not prevent a person from having a full and active life.
