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Mitral valve prolapse

Mitral valve prolapse (MVP) occurs when the valve between your heart's left upper chamber (left atrium) and the left lower chamber (left ventricle) doesn't close properly.

During mitral valve prolapse, the leaflets of the mitral valve bulge (prolapse) upward or back into the left atrium as the heart contracts.

Mitral (MY-trul) valve prolapse sometimes leads to blood leaking backward into the left atrium, a condition called mitral valve regurgitation.

In most people, mitral valve prolapse isn't life-threatening and doesn't require treatment or changes in lifestyle. Some people with mitral valve prolapse, however, require treatment.

Symptoms Causes Risk factors Complications Prevention

Although mitral valve prolapse is usually a lifelong disorder, many people with this condition never have symptoms. When diagnosed, people may be surprised to learn that they have a heart condition.

When signs and symptoms do occur, it may be because blood is leaking backward through the valve (regurgitation). Mitral valve prolapse symptoms can vary widely from one person to another. They tend to be mild and develop gradually. Symptoms may include:

  • A racing or irregular heartbeat (arrhythmia)
  • Dizziness or lightheadedness
  • Difficulty breathing or shortness of breath, often when lying flat or during physical activity
  • Fatigue
  • Chest pain that's not caused by a heart attack or coronary artery disease

When to see a doctor

If you think you have any of the above symptoms, make an appointment with your doctor.

Many other conditions cause the same symptoms as mitral valve prolapse, so only a visit to your doctor can determine the cause of your symptoms. If you're having chest pain and you're unsure if it could be a heart attack, seek emergency medical care immediately.

If you've already been diagnosed with mitral valve prolapse, see your doctor if your symptoms worsen.

When your heart is working properly, the mitral valve closes completely during contraction of the left ventricle and prevents blood from flowing back into your heart's upper left chamber (left atrium).

But in some people with mitral valve prolapse, one or both of the mitral valve's flaps (leaflets) have extra tissue bulging (prolapsing) like a parachute into the left atrium each time the heart contracts.

The bulging may keep the valve from closing tightly. When blood leaks backward through the valve, it's called mitral valve regurgitation.

This may not cause problems if only a small amount of blood leaks back into the atrium. More severe mitral valve regurgitation can cause symptoms such as shortness of breath, fatigue or lightheadedness.

Another name for mitral valve prolapse is click-murmur syndrome. When a doctor listens to your heart using a stethoscope, he or she may hear a clicking sound as the valve's leaflets billow out, followed by a murmur resulting from blood flowing back into the atrium. Other names to describe mitral valve prolapse include:

  • Barlow's syndrome
  • Floppy valve syndrome
  • Balloon mitral valve
  • Billowing mitral valve
  • Myxomatous mitral valve
  • Prolapsing mitral valve syndrome

Mitral valve prolapse can develop in any person at any age.

Serious symptoms of mitral valve prolapse tend to occur most often in men older than 50.

Mitral valve prolapse can run in families and may be linked to several other conditions, such as:

  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • Ebstein's anomaly
  • Muscular dystrophy
  • Graves' disease
  • Scoliosis

Although most people with mitral valve prolapse never have problems, complications can occur. They may include:

  • Mitral valve regurgitation. The most common complication is a condition in which the valve leaks blood back into the left atrium (mitral valve regurgitation).

    Being male or having high blood pressure increases your risk of mitral valve regurgitation. If the regurgitation is severe, you may need surgery to repair or replace the valve in order to prevent the development of complications, such as stroke.

  • Heart rhythm problems (arrhythmias). Irregular heart rhythms can occur in people with mitral valve prolapse. These most commonly occur in the upper chambers of the heart, and while they may be bothersome, they aren't usually life-threatening.

    People with severe mitral valve regurgitation or severe deformity of their mitral valve are most at risk of having serious rhythm problems, which affect blood flow through the heart.

  • Heart valve infection (endocarditis). The inside of your heart contains four chambers and four valves lined by a thin membrane called the endocardium. Endocarditis is an infection of this inner lining.

    An abnormal mitral valve increases your chance of getting endocarditis from bacteria, which can further damage the mitral valve. The risk is higher in older men.

    Doctors used to recommend that some people with mitral valve prolapse take antibiotics before certain dental or medical procedures to prevent endocarditis but not anymore.

    The American Heart Association advises that antibiotics aren't necessary in most cases for someone with mitral valve regurgitation or mitral valve prolapse.

You can't prevent mitral valve prolapse. However, you can lower your chances of developing the complications associated with it by making sure you take your medications, if any, as directed.

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