Mitral Valve Prolapse

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is mitral valve prolapse?

As blood flows in and out of the heart, it passes through several valves. Each valve contains two or more stiff tissue flaps called leaflets. The mitral valve controls blood flow between the left atrium and the left ventricle. Under normal conditions, the three leaflets of the mitral valve open to allow blood to flow from the left atrium into the left ventricle and then close tightly so that blood cannot regurgitate, or flow back the other way. However, some people are born with unusually soft mitral leaflets that cannot fully seal—a condition called mitral valve prolapse (MVP). Other people develop MVP due to conditions like rheumatic fever. MVP is the most common heart valve disorder, affecting 2 to 3% of the U.S. population.

Mitral prolapse, which is sometimes called Barlow syndrome, is most often due to a genetic defect. It is a congenital heart defect that tends to run in families, but it can occur spontaneously without a family history of the condition. Mitral valve prolapse can also occur in conjunction with certain genetic disorders, such as Marfan syndrome.

The most common sign of mitral valve prolapse is a distinctive heart murmur caused by blood regurgitating through the incompletely closed valve. Many people with mitral valve prolapse do not experience symptoms and never require treatment. In some cases, however, regurgitation from mitral valve prolapse can cause heart palpitations and fainting. If these symptoms become severe, a doctor may be able to treat the problem with a minimally invasive surgical procedure.

What are the symptoms of mitral valve prolapse?

A prolapsed mitral valve often does not produce any symptoms beyond a heart murmur. Some people live a lifetime with a faulty mitral valve and never experience any ill effects, while other people have severe symptoms.

Common symptoms of mitral valve prolapse

Mitral valve prolapse symptoms can include:

What causes mitral valve prolapse?

Mitral valve prolapse is caused by stretchy or floppy tissue leaflets in the valve. These floppy leaflets cannot seal adequately to stop blood from flowing backwards through the mitral valve.

Most people with MVP are born with it. The exact genetic cause of the heart defect is not known in most cases, but it is more common in people with connective tissue disorders. MVP also can be caused by rheumatic fever, which is a complication of untreated strep throat.

What are the risk factors for mitral valve prolapse?

Although most people with a prolapsed mitral valve are born with it, they may not experience problems or be diagnosed until later in life, sometimes well into the later decades. Mitral valve prolapse occurs more often in women than men. Not all people with risk factors will experience a prolapsed mitral valve. Risk factors for mitral valve prolapse include:

  • Advanced age

  • Connective tissue disorder including Marfan syndrome and Ehlers-Danlos syndrome

  • Family history of heart or valve disease, specifically mitral valve problems

  • Grave’s disease

  • Personal history of rheumatic fever

How is mitral valve prolapse treated?

Many cases of MVP do not require treatment. Your doctor will recommend a treatment plan based on the severity of your symptoms, your age, and your general health status. Common treatments for MVP include:

  • Medicines to treat heart palpitations or arrhythmias

  • Minimally invasive mitral valve repair procedure

  • Open surgery to replace the mitral valve

What are the potential complications of mitral valve prolapse?

Severe mitral valve prolapse that allows large volumes of blood to flow backwards from the ventricle to the atrium can cause a heart arrhythmia, which in turn increases the risk of stroke. A prolapsed mitral valve also can cause heart failure and increase your risk of developing infective endocarditis, a condition that causes inflammation and damage to the interior lining of the heart.

People with a mitral valve prolapse diagnosis should have periodic checkups with a cardiologist to monitor the condition and start treatment if necessary.  

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jan 25
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