Mitral Valve Prolapse
Treating Cardiovascular Diseases in Wisconsin and Northern Illinois
Although mitral valve prolapse, or MPV, is the most common heart valve abnormality, only a small percentage of those with this condition experience symptoms of mitral valve prolapseor require treatment.
The mitral valve is located on the left side of the heart, between the upper and lower chambers. The two upper chambers of the heart are known as the atria; the two lower chambers are known as the ventricles.
With each heartbeat, the mitral valve opens to allow blood through the left atrium and into the left ventricle, which then contracts to pump blood out of the heart to the rest of the body. When this ventricle contracts, the leaflets or flaps of the mitral valve close.
As the valve closes, the leaflets shouldclose tightly to ensure that blood flows in only one direction. When the mitral valve prolapses, it often prevents a tight seal from forming. This allows blood to leak back into the left atrium, a condition known as regurgitation.
Symptoms of Mitral Valve Prolapse
Symptoms of mitral valve prolapse exist only when regurgitation occurs and may include:
- Chest pain or discomfort
- Fatigue, dizziness or anxiety
- Irregular heartbeats or palpitations
- Shortness of breath or coughing
Sometimes regurgitation gets worse over time. This can make symptoms worse or lead to chronic rhythm disturbances, such as atrial fibrillation. Since mitral valve prolapse is an abnormality of the valve structure, patients who have this condition are at risk for developing infective endocarditis, an infection of the inside lining of the heart. Learn more about infective endocarditis symptoms and atrial fibrillation symptoms.
Risks and Causes of Mitral Valve Disease
The exact cause of mitral valve prolapse isn’t known but there is a strong hereditary tendency. MVP can occur at any age but women age 20 to 40 are most commonly affected. It is also associated with the following conditions:
- Connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome
- Polycystic kidney disease
Diagnosing Mitral Valve Disease
Mitral valve prolapse is usually diagnosed during a routine physical exam when doctors hear a specific click-murmur sound when listening to the heart with a stethoscope.
In the past, MVP was thought to affect 5 to 15 percent of the general population. It is now believed to affect less than 3 percent of the population. This is due in part to advances in imaging technology. Echocardiography, or ultrasound of the heart, allows doctors to see MVP and regurgitation more clearly. Types of ultrasound testing used in diagnosing MVP include:
- Stress echocardiography
- Transesophageal echocardiography or TEE
- Transthoracic echocardiography or TTE
Other tests may include:
- A chest X-ray
- Cardiac catheterization
- Magnetic resonance imaging
Electrocardiogram testing or EKG
Treating Mitral Valve Prolapse
Most people who have MVP do not have any symptoms or complications that require treatment. In fact, many may not even know they have this condition.
Treatment is necessary only when backflow or regurgitation exists. In these cases, the goals of treatment include:
- Correcting the underlying mitral valve problem
- Preventing further complications, such as infective endocarditis or arrhythmias
- Relieving symptoms
Treatment may involve medications, a mitral clip procedure or surgery. Your doctor may prescribe any of the following:
- Anti-arrhythmic medications to regulate your heart rhythm
- Blood-thinning medications to reduce the risk of blood clots forming
- Digoxin to strengthen your heart beat
- Diuretics to remove excess fluid in your lungs
- Medications to treat palpitations and chest discomfort
- Vasodilators to widen your blood vessels and reduce your heart’s workload
Aurora St. Luke’s Medical Center is the only center in Wisconsin that uses a catheter-based approach when implanting a mitral clip on the mitral valve. The clip narrows the valve just enough to stop or reduce the leak. It is an excellent option for patients who are older or have had prior heart surgeries.
Doctors recommend valve surgery(link tbd) when the degree of mitral valve regurgitation or leakage becomes severe. Valve repair is preferred over valve replacement because it allows individuals to keep their native valve, which lowers the risk of infection, decreases the need for life-long use of blood-thinning medications and reduces the need for future interventions on the valve.
In the past, doctors routinely performed valve surgeryby making an incision in the breastbone and exposing the heart. Today, doctors at Aurora St. Luke’s use robotically assisted mitral valve repair for a select group of people, which is performed through a few small incisions on the right side of the chest wall. This approach allows patients to recover more quickly and have shorter hospital stays than with traditional surgery.
If repair isn’t an option, the valve can be replaced with mechanical or biological valve. Mechanical valves are man-made and can last a lifetime. However, people with mechanical valves need to take blood-thinning medications for the rest of their lives. Biological valves are taken from cows or pigs, or made from human tissue. Although they don’t require blood-thinning medications, they gradually wear out with time.
A Multidisciplinary Approach to Treating Heart Valve Disease
Aurora Health Care has a multidisciplinary team of specialists with extensive experience in diagnosing, evaluating and treating patients with valvular heart disease. In 2011, Aurora St Luke’s opened The Valvular Heart Disease Center to recognize and define specific valve disorders, and determine appropriate timing for medical and surgical treatments to help patients thrive for a lifetime.
The physicians and staff of Aurora Health Care Valve Services are also very active in developing new strategies to treat heart valve disease. We have participated in several major studies on new devices to replace heart valves using a percutaneous (catheter) approach that does not require a surgical incision.
Aurora doctors are conveniently located throughout eastern Wisconsin and northeastern Illinois. Find a doctor or heart specialist near you. To get a second opinion or if you need assistance finding a provider, please call 888-649-6892.