Mitral prolapse syndrome . Also known as Barlow’s disease , although it is generally benign, in some individuals it can present with a marked mitral regurgitation and great ventricular dilation.
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- 1 Causes
- 2 Symptoms
- 3 Tests and reviews
- 4 Treatment
- 5 Forecast
- 6 Possible complications
- 7 Sources
The mitral valve helps blood on the left side of the heart flow in one direction and closes to prevent blood from returning when the heart beats (contracts). Mitral valve prolapse is the term used when the valve does not close properly and can be caused by many different things.
In most cases, it is harmless, and patients usually don’t know they have the problem. Up to 10% of the population has some minor and insignificant form of mitral valve prolapse, but it generally does not affect lifestyle.
In a small number of cases, prolapse can cause blood to leak and return, which is called mitral regurgitation. Mitral valves that are structurally abnormal can increase the risk of bacterial infection. Some forms of mitral valve prolapse appear to be passed down from parents to offspring (inherited). This condition has also been associated with Graves’ disease.
Mitral valve prolapse often affects thin women who may have minor chest wall deformities, scoliosis, or other disorders. This prolapse is associated with some connective tissue disorders, especially Marfan Syndrome . Other conditions include:
- Ehlers-Danlos syndrome
- Imperfect osteogenesis
- Polycystic kidney disease
Many patients with mitral valve prolapse have no symptoms. The group of symptoms found in patients with this prolapse is called “mitral valve prolapse syndrome” and includes:
- Feeling of perceiving the heartbeat (palpitations).
- Panic attacks.
- Chest pain (not caused by coronary artery disease or heart attack).
- Difficulty breathing after an activity.
- Respiratory failure when lying down (orthopnea).
There may be no symptoms or they may appear slowly. When mitral regurgitation occurs, symptoms may be related to this leak.
Tests and exams
The doctor will perform a physical exam and use a stethoscope to listen to the heart and lungs. The provider may feel a thrill (vibration) over the heart and hear a heart murmur (“mesosystolic click”). The murmur feels louder when you stand up. Blood pressure is generally normal.
The following tests can be used to diagnose mitral valve prolapse or a patent mitral valve:
- Color Doppler flowmetry
- Cardiac catheterization
- Chest x – ray
- ECG (may show arrhythmias such as atrial fibrillation)
- Magnetic resonance imaging of the chest
- CT scan of the chest
In most cases, there are few or no symptoms and no treatment is required. If someone has severe mitral valve prolapse, they may need hospitalization. Also, valve repair or replacement surgery may be needed if the person has severe mitral regurgitation or if symptoms worsen. Mitral valve replacement may be necessary if:
- You have symptoms
- The left ventricle of the heart is dilated.
- Heart function worsens (depressed ejection fraction).
In the past, some people with mitral valve prolapse were given antibiotics before certain dental or surgical procedures to help prevent an infection called bacterial endocarditis .
However, the American Heart Association no longer recommends routine antibiotics before dental procedures or other surgical procedures for patients with mitral valve prolapse only, unless they have had bacterial endocarditis in the past.
Other drugs that can be prescribed when mitral regurgitation or other heart problems also occur:
- Antiarrhythmics that help control irregular heartbeat.
- Diuretics that help flush excess fluid from the lungs.
- The propranolol administered for palpitations or chest pain.
- Anticoagulants that help prevent clots from forming in people who also have atrial fibrillation.
Mitral valve prolapse should not adversely affect your lifestyle. If the leaky valve becomes severe, the outlook may be similar to that of people who have mitral regurgitation from another cause.
Most of the time, the condition is harmless and asymptomatic. When symptoms occur, they can be treated and controlled with medicine or surgery. However, some irregular heartbeats (arrhythmias) associated with mitral valve prolapse can be life-threatening.
- Endocarditis (infection of the valves)
- Severely leaky mitral valve (regurgitation)
- Clots to other areas
- Irregular heartbeat (arrhythmias), including atrial fibrillation