Living Well with Mitral Valve Prolapse

What Is Mitral Valve Prolapse (MVP)?

Mitral Valve Prolapse (MVP) happens when the flaps of the mitral valve are too flexible or floppy, causing them to push back into the left atrium when the mitral valve separates the left atrium and left ventricle. During heart contraction, one or both valve leaflets parachute into the atrium, triggering a prolapse mechanism.  Blood flowing backward might cause a heart murmur.

Mitral Valve Prolapse Types

Types of mitral valve prolapse (MVP) depend on the cause and valve structure. A clear breakdown:

1. Myxomatous primary MVP

• Idiopathic valve tissue degeneration.
• Features:
• Thick, redundant valve leaflets
• Elongated valve-anchoring chordae tendineae
• Related to connective tissue illnesses like Marfan syndrome
• Also called Barlow's syndrome

2. Second MVP

• Cause: Other heart problems or structural alterations.
• Features:
• Left ventricular dysfunction or ischemic heart disease causes valve prolapse.
• Leaflets may look normal, but prolapse is functional.

3. Classic vs. Non-Classic MVP

• Classic MVP:
• Leaflet displacement ≥2 mm above the mitral annulus
• Leaflet thickness ≥5 mm
• Non-Classic MVP:
• Leaflet displacement ≥2 mm
• Leaflet thickness < 5 mm
• The risk of mitral regurgitation can be assessed by this differentiation.

Mitral valve prolapse signs

Mitral Valve Prolapse (MVP) symptoms range from none to heart problems. This systematic summary uses current clinical sources.

Common MVP symptoms

• Palpitations: Fast or irregular pulse
• Sharp or stabbing chest pain, usually unrelated to effort.
• Fatigue: Especially when exercising
• Shortness of breath: Can happen whether exercising or lying down.
• Unsteadiness
• Panic or anxious feelings
• Standard examinations often reveal heart murmurs.

Complication symptoms (Mitral Regurgitation)

• Leg or foot swelling
• Cough, especially at night or when lying down
• Breathing problems during exercise
• Uneven heartbeat (atrial fibrillation)

Note: Many asymptomatic patients with MVP are diagnosed following an echocardiogram or physical examination. Stress and exhaustion might worsen symptoms.

Also, read https://www.rush.edu/conditions/mitral-valve-prolapse.

Causes and Risks

• Connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome, can increase the elasticity of valve tissue.
• Families can inherit MVP.
• Age and sex: This condition is diagnosed in young adults and is more common in women.

Is it Dangerous?

• MVP patients are generally asymptomatic and lead normal lives.
• Possible problems include exhaustion, palpitations, and dyspnea, which could be signs of severe regurgitation that needs valve replacement or repair.

How is mitral valve prolapse diagnosed?

You will be examined by your physician if you have symptoms of mitral valve prolapse. They'll use a stethoscope to listen for the condition's sound in your heart.

• If your doctor suspects MVP, additional testing can confirm it. Tests your doctor may prescribe include:
• Acoustic echocardiograms show your heart in motion in real time. Your doctor can inspect your mitral valve and check for prolapse with this test.
• ECG/EKG: Measures the heart's electrical activity. Though many MVP patients have normal EKGs, it can detect abnormal heartbeats.
• Chest X-ray: Assesses heart and lung health.
• Chest CT scan: Shows mitral valve and other cardiac components. Examining the coronary arteries, which supply blood to the heart, is another option.
• Exercise tests: Your physician might ask you to walk on a treadmill while your heart is being monitored. These tests can determine your heart's response to exercise and MVP symptoms.

Echocardiogram mitral valve prolapse

MVP is diagnosed primarily by echocardiography. A chest probe is used in this painless, noninvasive procedure to scan deeper parts, including the heart. This probe is similar to an ultrasound in that it records moving cardiac images, which your doctor can use to determine the degree of mitral valve prolapse.

Doctors may recommend transesophageal echocardiograms for further detail. This test examines the mitral valve and its supporting components. For a better view of the heart, your doctor will sedate you and then gently insert a thin tube with a tiny ultrasound probe down your throat and into your esophagus.

Does mitral valve prolapse worsen with age?

• In rare cases, Mitral Valve Prolapse (MVP) worsens with age.
• Most instances are stable over time. MVP is generally asymptomatic throughout life.
• Risk of progression: In rare situations, especially those with severe mitral regurgitation (leakage), the disease may deteriorate.
• Age-related changes: The valve tissue may become fibrotic or calcified with age, worsening prolapse or regurgitation.
• Arrhythmias, atrial enlargement, and heart failure can result from MVP progression.

Watching and Preventing

• Regular echocardiograms: Monitor valve function and regurgitation.
• Lifestyle changes: Limiting caffeine intake and controlling blood pressure may reduce valve strain.
• Early intervention: It is important to evaluate symptoms like palpitations, fatigue, and dyspnea as soon as possible.

Mitral valve prolapse lifespan

• MVP rarely shortens life expectancy. The following factors affect prognosis:
• Average MVP lifespan
• Most cases are harmless. Mild MVP without mitral regurgitation leads to a healthy life.
• Unneeded intervention: Many people never need surgery or drugs.

When does MVP May Impact Lifespan?

• With severe mitral regurgitation, the valve might leak and cause cardiac failure, arrhythmias, or stroke.
• Untreated problems can diminish life expectancy without monitoring or treatment.
• Surgical outcomes: Valve repair or replacement improves cardiac function and survival.

Key Prognostic Factors

• Level of valve leakage
• Palpitations, tiredness, breathlessness
• Heart rhythm issues
• Early diagnosis and treatment

Is mitral valve prolapse dangerous?

Mitral Valve Prolapse (MVP) is normally harmless, but the consequences can be serious.

When is MVP Safe?

• Most have no symptoms and live normally without treatment.
• Mild MVP without mitral regurgitation is benign.
• Regular monitoring usually suffices.

MVP Risks

• Severe mitral regurgitation: Significant valve leakage can strain the heart and cause:
• Heart enlargement
• Heart failure
• Uneven heartbeat (atrial fibrillation)
• Blood clot stroke risk

Complications are rare:

• Endocarditis: Heart valve infection, particularly regurgitation
• Extreme valve dysfunction and arrhythmias can cause sudden cardiac arrest, which is rare.

What should mitral valve prolapse patients avoid?

• Certain lifestyle and substance choices might cause palpitations, tiredness, and dizziness in MVP patients. MVP is normally harmless; however, avoiding things can improve your health and prevent complications:

Avoidances for MVP Stimulants:

• Too much caffeine (coffee, energy drinks, chocolate)
• Smoking, vaping nicotine
• OTC decongestants like pseudoephedrine
• Alcohol might aggravate palpitations and blood pressure swings.

Very processed foods:

• Sugar, salt, and harmful fats may raise blood pressure and inflammation.

Stress and insufficient sleep:

• Emotional strain and lack of sleep may exacerbate MVP symptoms like chest pain and anxiety.

Restless lifestyle:

• Regular exercise is safe and useful, but avoid overexertion if regurgitation is severe.

Unmonitored drugs:

• Before starting new medications, ask your doctor. Some may elevate blood pressure or affect heart rhythm.

What You Can

• Eat fruits, vegetables, and whole grains for heart health.
• Stay hydrated.
• Practice yoga and meditation to reduce stress.
• Regularly check an echocardiogram

The video explains the Mitral valve regurgitation

Medication and Treatment

Mitral Valve Prolapse (MVP) treatment depends on severity and symptoms, such as mitral regurgitation. The overview is structured as follows:

MVP treatment options

1. Lifestyle, Monitoring

• Mild, asymptomatic MVP requires no therapy.
• Regular echocardiograms for valve monitoring.
• Drink less caffeine, minimize stress, and exercise.

2. Medication: 

• This manages symptoms or consequences but does not repair the prolapse.
• Beta-blockers: Reduce heart rate and palpitations. Metoprolol, Atenolol
• Control irregular heartbeats with antiarrhythmics. Amiodarone, Flecainide
• Diuretics: Reduce heart failure fluid overload. Furosemide and ACE inhibitors reduce stress and blood pressure. Enalapril, Lisinopril
• Anticoagulants prevent atrial fibrillation clots. Warfarin, Apixaban

3. Surgery

• Mitral valve repair: When possible, repair over replacement.
• In severe situations with irreparable damage, replace the mitral valve.
• At speciality clinics, minimally invasive procedures are available. 

Self-care tips

• Stay away from caffeine and nicotine.
• Regulate anxiety and sleep
• Stay hydrated and eat heart-healthy.

Conclusion

MVP is not harmful, although palpitations, tiredness, and shortness of breath require monitoring. With sufficient attention, even complicated cases can succeed.