Mitral Valve Prolapse


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Mitral valve prolapse (MVP) affects about 2% of people in the United States. 1 (Past estimates were higher due to errors in diagnosis.) As the name suggests, MVP involves prolapse of one of the valves of the heart, the mitral valve. The mitral valve sits at the opening between the left atrium and left ventricle, and opens and closes so that blood flows only in one direction (atrium to ventricle). In MVP, the mitral valve fails to make a proper snug fit, and instead billows (prolapses) back into the atrium, making a sound that can be heard through a stethoscope.MVP is generally benign. Sometimes, however, the mitral valve fits so poorly that a large amount of blood leaks back from the ventricle to the atrium. This is called “mitral regurgitation,” and it can be dangerous, eventually requiring surgery. In the past, a set of symptoms called dysautonomia was thought to frequently occur in association with MVP. Dysautonomia involves malfunction of the autonomic nervous system (the part of the nervous system that is not under conscious control). MVP plus dysautonomia used to be called the “Mitral Valve Prolapse Syndrome.” Symptoms were said to include:

  • Chest pain with no apparent medical cause
  • Panic attacks/anxiety
  • Heart palpitations
  • Sweating
  • Dizziness
  • Lightheadedness
  • Weakness
  • Balance problems
  • Hypersensitive startle reflex
  • Shortness of breath
  • Numbness or tingling in the fingers or toes
  • Hyperventilation
  • Sensitivity to caffeine and other stimulants
However, recent evidence indicates that symptoms of dysautonomia occur with no greater frequency in people with MVP than in people without MVP. In other words, there is probably no connection between the two conditions. People who were previously diagnosed with MVP Syndrome are now said to have two separate conditions: MVP plus symptoms of dysautonomia. The cause of these dysautonomic symptoms is not clear, but probably involves a response to stress.Conventional treatment for MVP involves regular monitoring for mitral regurgitation, along with maintenance of normal weight and blood pressure to avoid excess strain on the valve. In addition, people with MVP are given antibiotics prior to surgical or dental procedures. Those procedures may release bacteria into the bloodstream and, in people with MVP, bacteria may stick to the valves and cause infection (a condition called endocarditis). Antibiotic treatment can prevent this.People with MVP who also have symptoms of dysautonomia may be separately treated for those symptoms as well.

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