You have two chambers on the left side of your heart: your left atrium and your left ventricle. Your mitral valve, which is located between the two, is designed to allow blood to flow into the left ventricle but blocked from flowing back into the left atrium.
In mitral valve prolapse (MVP), also called Barlow’s syndrome, the flaps of the mitral valve do not close correctly. Instead, the valve bulges into the atrium. This can lead to mitral valve regurgitation, which means that blood leaks back into the left atrium through the prolapsed valve.
Only about three percent of Americans have mitral valve prolapse, according to the National Heart, Lung, and Blood Institute, and among these cases, serious complications are uncommon. (NHLBI) Most of the time, people with MVP do not have any symptoms, and it does not affect their daily lives.
Experts do not know exactly what causes MVP. Most people are born with abnormalities that cause the condition. These may include mitral valve flaps that are too big, thick, or stretchy. (NHLBI)
The Mayo Clinic reports that MVP is most commonly found in men over age 50. (Mayo) It is also found more often in people born with disorders of the connective tissue (collagen, ligaments, tendons, etc.).
MVP often runs in families, so you may be more likely to have it if your parents or other relatives do.
Certain conditions may lead to mitral valve prolapse. These include:
- scoliosis–curvature of the spine
- adult polycystic kidney disease–a genetic condition in which large cysts interfere with kidney function
- Connective tissue problems such as Marfan’s syndrome–a genetic condition that affects the connective tissue of the skeletal and cardiovascular systems, eyes, and skin
Because mitral valve prolapse often causes no symptoms, most people with this condition are unaware that they have heart problems.
If you do develop symptoms, they will generally be mild. The onset of symptoms is typically slow and gradual rather than abrupt.
When symptoms do occur, they may include:
- fatigue and tiredness
- shortness of breath, especially during exercise or when lying flat
You might also develop migraines (recurring headaches that can cause nausea) or experience pain in your chest. This pain is not caused by heart muscle blood flow seen with heart attacks. Your heartbeat might feel fast or irregular.
Your doctor will generally perform several tests to better understand your heart before making a diagnosis.
In most cases, your doctor will initially detect MVP when using a stethoscope to listen to your heart. If you have the condition, your heart may make a clicking sound when it beats. This sound is usually more noticeable when you are standing. Hearing this click might lead your doctor to order further tests.
Your doctor may order an X-ray and/or an echocardiogram. Both of these tests provide images of your heart, but the echocardiogram shows more structural details. Your doctor can check the images to see if you have MVP or regurgitation. Depending on your condition, your doctor may also perform a cardiac catheterization. In this procedure, dye (which is visible on X-rays) is injected into the arteries of your heart using a catheter (tube) that has been threaded through a blood vessel in your neck, arm, or upper thigh.
Your doctor might ask you to exercise on a treadmill or perform some other physical activity to see how your heart responds. This is called a stress test.
An electrocardiogram (ECG) is a way to check your heartbeat for irregularities. It is a recording of a few seconds of your heart’s electrical activity. This can help your doctor diagnose mitral valve prolapse or other heart conditions.
In most cases, you won’t need any treatment for mitral valve prolapse. However, if you have noticeable symptoms, your doctor might choose to treat your condition.
Treatment often involves taking medications to help relieve any symptoms you’re experiencing. Possible medications your doctor might prescribe include:
- aspirin–to reduce the risk of blood clots
- beta blockers–to prevent your heart from beating irregularly and to improve blood flow
- blood thinners–to prevent blood clots
- diuretics–to remove excess fluid from the lungs
- vasodilators–to widen the blood vessels and improve blood flow
If your condition is more serious, such as if you have severe regurgitation or impaired heart function, you may need surgery. There are two basic types of surgery for this issue: valve replacement and valve repair. Your doctor will generally opt to repair the valve if possible.
If repairing the valve isn’t possible, it may be replaced with either a man-made mechanical valve or a biological valve harvested from a cow or pig or created from human tissue. There are pros and cons to both kinds of valves, so your doctor will discuss your options with you before the procedure.