What do I need to know about mitral valve prolapse?
Among heart defects, mitral valve prolapse is the most common. According to the American Heart Association, about 2% of the population has this form of mitral valve malformation.
Mitral valve prolapse
Before discussing the details of mitral valve prolapse, its symptoms, risk factors, and treatment, let's look at the anatomy of the mitral valve and the function of this fibrous valve in the human heart.
What is the mitral valve?
The mitral valve is one of the four valves in the human heart. The mitral valve controls the flow of blood between the two chambers of your heart, called the left atrium and left ventricle. In a normally functioning heart, blood flows through the mitral valve in one direction, from the atrium to the ventricle.
Heart valves
Unlike the other three heart valves (aortic, pulmonary, and tricuspid valves), the mitral valve consists of only two flaps. Each of the other human heart valves has three leaflets.
These two flaps open to allow blood to flow from the atrium to the ventricle. The flaps attach to the mitral valve ring, which has a saddle-shaped structure. The central end of the flaps is connected to the heart wall by papillary muscle chords. During heart contraction, these chords prevent the valve leaves from moving into the left atrium. The following figure shows the development of prolapse as a result of the disruption of this mechanism.
What is a mitral valve prolapse?
If you have a mitral valve prolapse, it is an indication that the mitral valve leaflets are not closing properly. During the heartbeat, one of the flaps moves toward the atrium. Blood flows out in the opposite direction because of a “prolapse”. This is called mitral insufficiency (regurgitation).
This is a very good picture comparing the mitral valve in prolapse with a normal mitral valve. As you can see, the two mitral valve leaflets are not closing against each other. As a result, blood flows back into the atrium.
What develops mitral valve prolapse?
In most cases, people are born with congenital mitral valve prolapse. As the anatomical structures of the mitral valve age over the life of the patient, the disease can become degenerative. Studies show that 20% of these people develop mitral valve disease over the age of 50 years.
Women suffer from this disease twice as often as men. Some studies show that mitral valve defect occurs in 6% of women.
Mitral valve prolapse (MVP) is the most common valve defect of the heart.
What are the main symptoms of mitral valve prolapse?
The symptoms of mitral valve prolapse include:
- Heart palpitations
- Intermittent pain in the chest area
- Confused breathing
- Dizziness
- Anxiety
Your doctor may diagnose mitral valve prolapse during regular checkups. During auscultation of the heart with a stethoscope, your doctor may hear a “clicking sound”. A defective heart valve may make a distinct “clicking” sound when it opens and closes. If blood is flowing back into the atrium, your doctor will hear a “systolic noise”. This sound is called a mitral valve murmur.
Your cardiologist should perform an echocardiography (EchoCG) to determine if your mitral regurgitation is mild, moderate, or severe. Echocardiography assesses heart valve function as blood flows out of the heart. EchoCG and other tests can help your doctor determine if your mitral valve needs surgery or prosthetic repair.
What are the risks of mitral valve prolapse?
There are several risks with severe mitral valve failure that develops as a result of mitral valve prolapse:
- Heart failure
- Atrial fibrillation (AF)
- Pulmonary hypertension
How is mitral valve prolapse treated?
There are two types of treatment for mitral valve prolapse:
Mitral valve repair: During mitral valve repair, the patient's mitral valve is restored to allow proper blood flow. The repair process may include reshaping the mitral valve leaflets, strengthening the mitral ring with an annuloplasty ring, and replacing the mitral valve chords.
Mitral valve repair is open heart surgery. However, there are minimally invasive approaches that include mitral valve repair without incising the patient's sternum. You can read more about this in our articles “Minimally Invasive Heart Surgery” and “Minimally Invasive Mitral Valve Plasty”.
Mitral valve prosthetics. Currently, there are several types of mitral valve prostheses. Currently, minimally invasive mitral valve replacement surgeries, which do not require incision of the patient's sternum, are successfully performed in our clinic.