Mitral valve prolapse

Description

Prolapse of the Mitral valve is a type of heart valve disease that affects the valve between the left heart chambers. The flaps (leaflets) of the mitral valve are floppy. Stand back (prolapse) as a parachute in the heart of the upper-left of the camera as the heart squeezes (contracts).

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

Generally, mitral valve prolapse is not life threatening and do not require treatment or changes in lifestyle. But some people may need medications or surgery, especially if the prolapse cause severe regurgitation.

Other names to describe mitral valve prolapse include:

  • Barlow syndrome
  • That emanates from the mitral valve syndrome
  • Click-murmur syndrome
  • Floppy valve syndrome
  • Mitral Prolapse
  • Disease of the mitral valve myxomatous

Symptoms

The signs and symptoms of mitral valve prolapse due to the amount of blood leaking backwards through the valve.

Mitral valve prolapse symptoms can vary widely from one person to another. Many people with mitral valve prolapse do not have obvious symptoms. Other people may have mild symptoms that develop gradually.

The symptoms of prolapse of the mitral valve may include:

  • A racing or irregular heart rhythm (arrhythmia)
  • Dizziness or lightheadedness
  • Difficulty breathing or shortness of breath, especially during exercise or when lying down
  • Fatigue

When to see a doctor

If you have symptoms of mitral valve prolapse, make an appointment with your health care provider. Many other conditions can cause similar symptoms.

If you are having unusual or sudden chest pain or think they are having a heart attack, seek emergency medical attention immediately.

If you have been diagnosed with mitral valve prolapse, talk to your doctor if your symptoms get worse.

Causes

To understand the causes of the disease of the mitral valve, can be useful to know how the heart works.

The mitral valve is one of the four heart valves that keep blood flowing in the right direction. Each valve has flaps (leaflets) that open and close once during each heartbeat. If a valve does not open or close properly, the blood flow through the heart in the body can be reduced.

In mitral valve prolapse, one or both of the leaflets of the mitral valve have extra tissue or stretch more than usual. The booklets can protrude backwards (prolapse) as a parachute at the top left of the chamber of the heart (the left atrium) every time the heart contracts to pump blood.

The lump may keep the valve from closing tightly. If blood leaks back through the valve, the condition is called mitral valve regurgitation.

Risk factors

Mitral valve prolapse can develop in any person at any age. Severe symptoms of mitral valve prolapse tend to occur more often in men older than 50 years.

Mitral valve prolapse can occur in families (to be inherited) and can be linked to several other conditions, including:

  • Epstein anomaly
  • The Ehlers-Danlos syndrome
  • Graves disease
  • Marfan syndrome
  • Duchenne Muscular dystrophy
  • Scoliosis

Complications

The potential complications of mitral valve prolapse may include:

  • Regurgitation of the Mitral valve. The leaflets of the mitral valve does not close tightly. The blood flows backward when the valve is closed, making it more difficult for the heart to work properly. The fact of being a man or having high blood pressure increases the risk of regurgitation of the mitral valve.
  • Heart rhythm problems (arrhythmias). Irregular heartbeats can occur if the prolapse of the mitral valve leading to a severe regurgitation and the swelling of the upper left chamber of the heart (atria).

Mitral valve prolapse

Diagnosis

To diagnose mitral valve prolapse, your health care provider will usually do a physical exam and listen to your heart with a stethoscope.

If you have mitral valve prolapse, a clicking sound can be heard through a stethoscope. If blood is leaking backward through the mitral valve, a sibilant sound (murmur) also can be heard.

Tests

Tests that may be performed to help confirm mitral valve prolapse, and to assess the heart include:

  • The echocardiogram.An echocardiogram uses sound waves to create images of the heart in motion. An echocardiogram standard, also called a transthoracic echocardiogram (TTE), can confirm a diagnosis of mitral valve prolapse and to determine its severity. Sometimes, a transesophageal echocardiogram (TEE) can be done to get more detailed images of the mitral valve. In this type of echocardiogram, a small transducer attached to the end of a tube that is inserted into the tube that goes from the mouth to the stomach (esophagus).
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. It can help to show whether the heart is enlarged.
  • Electrocardiogram (ECG or EKG). This quick and painless test that measures the electrical activity of the heart. An ECG can detect irregular heart rhythms (arrhythmias) associated with mitral valve disease.
  • Exercise or stress of exams. These tests often involve walking on a treadmill or riding a stationary bike while the heart is controlled with the ECG. Exercise tests can help reveal how the heart responds to physical activity and if mitral valve prolapse symptoms occur during the exercise. If you're unable to exercise, you may be given drugs that mimic the effect of exercise on the heart.
  • The cardiac catheterization. This test is not often used to diagnose mitral valve prolapse, but may be useful if other tests are not diagnosed with the disease. A health care provider, threads a thin tube (catheter) through a blood vessel in the arm or in the groin to an artery in the heart and is used to inject a dye through the catheter. This causes the arteries in the chambers of the heart are shown more clearly on x-rays.

The echocardiogram. An echocardiogram uses sound waves to create images of the heart in motion. An echocardiogram standard, also called a transthoracic echocardiogram (TTE), can confirm a diagnosis of mitral valve prolapse and to determine its severity.

Sometimes, a transesophageal echocardiogram (TEE) can be done to get more detailed images of the mitral valve. In this type of echocardiogram, a small transducer attached to the end of a tube that is inserted into the tube that goes from the mouth to the stomach (esophagus).

Treatment

Most people with mitral valve prolapse, particularly those without symptoms do not require treatment.

If you have mitral valve regurgitation, but does not have symptoms, the doctor may recommend regular checkups to monitor your condition.

If you have severe mitral valve regurgitation, medication or surgery may be necessary even if you have no symptoms.

Drugs

You may need medications to treat irregular heartbeats or other complications of mitral valve prolapse. The medications include:

  • Beta-blockers. These medicines relax blood vessels and reduce the beats of the heart, which reduces the blood pressure.
  • Water pills (diuretics). These medicines help to eliminate the salt (sodium) and water through urine, reducing the blood pressure.
  • The heart rhythm drugs (antiarrhythmics). You can use medications to help control irregular heart rhythms.
  • Blood thinners (anticoagulants). If the disease of the mitral valve is causing an irregular heartbeat called atrial fibrillation, your health care provider may recommend medication to thin the blood to prevent the formation of blood clots. Atrial fibrillation increases the risk of blood clots and strokes. If you had mitral valve replacement with a mechanical valve, blood thinners are necessary for life.
  • Antibiotics. The American Heart Association says that antibiotics are not usually necessary for someone with mitral valve prolapse. But if you have had mitral valve replacement, your health care provider may recommend taking antibiotics before dental procedures to prevent infection of the heart, called infective endocarditis.

Surgery and other procedures

Most people with mitral valve prolapse do not need surgery. But surgery may be recommended if mitral prolapse causes of severe mitral regurgitation, whether or not you have symptoms.

The surgery for a sick or damaged mitral valve included mitral valve repair or mitral valve replacement. Mitral valve repair is preferred because it saves the existing valve.

Valve repair and replacement can be done through open-heart surgery or minimally invasive surgery. Minimally invasive surgery involves smaller incisions and may have less blood loss and a shorter recovery time.

During the repair of the mitral valve surgery, the surgeon can remove excess tissue of the prolapse of the valve flap can close tightly. The surgeon can also replace the cables that support the valve. Other repairs can also be done.

If the mitral valve repair is not possible, the valve can be replaced. During mitral valve replacement surgery, the surgeon removes the mitral valve and replaces it with a mechanical valve or a valve from a cow, pig or human heart tissue (biological tissue valve).

Sometimes, a heart catheter procedure is done to replace a valve replacement in a biological tissue valve that is not working well. This is called a valve-in-valve procedure.

Self-care

If you have mitral valve prolapse, you'll have regular follow-up appointments with your health care provider to help control your condition.

It is also important to take steps to keep your heart healthy.

  • Eating a heart-healthy diet. Eat a variety of fruits and vegetables. Choose low-fat or non-fat dairy products, poultry, fish and whole grains. Avoid saturated and trans fats, and excess sugar and salt.
  • Maintain a healthy weight. If you are overweight or obese, your doctor may recommend that you lose weight.
  • Get regular physical activity. Most people with mitral valve prolapse are able to perform daily activities and exercise without restrictions. Aim to include about 30 minutes of physical activity, such as brisk walking, on his daily exercise routine. If the prolapse of the mitral valve causes the reflux is severe, your doctor may recommend certain exercise of limitations.
  • Manage stress. Do more exercise, connect with others, and the practice of mindfulness are some of the ways to reduce stress.
  • Avoid tobacco. If you smoke, stop smoking. Ask your health care provider about resources to help you quit smoking.

Preparing for your appointment

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do beforehand.
  • Write down your symptoms, including any that may seem unrelated to prolapse of the mitral valve, and when they began.
  • Write down key personal information, including a family history of heart disease, heart defects, genetic disorders, stroke, high blood pressure or diabetes, and any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements that you take, including over-dose.
  • Have a family member or friend along, if possible. Someone who accompanies you can help you remember the information they give you.
  • Be prepared to discuss your diet and exercise habits. If you do not already follow a diet or workout routine, be ready to talk with your health care provider about the challenges that you might face in the introduction.
  • Write questions to ask their provider.

For prolapse of the mitral valve, some basic questions to ask your health care provider include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes?
  • What tests do I need?
  • I need treatment? What kind?
  • What are the alternatives to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • You should see a specialist?
  • If I need surgery, a surgeon who you recommended for the repair of the mitral valve?
  • Is there a generic alternative to the medicine you're prescribing for me?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

Don't hesitate to ask any questions you may have.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

  • Do you always have symptoms, or the symptoms come and go?
  • How severe are the symptoms?
  • What makes the symptoms better?
  • What makes symptoms worse?
Symptoms and treatment of prolapse of the Mitral valve