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Mitral Valve Prolapse

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The human heart is a factory that runs continuously, pumping blood and supplying oxygen to each and every part and cell of the body. There are two ventricles that pump blood into two other chambers called the atria. Each and every part of the heart works in tandem to ensure smooth working of the blood circulation system. Any problems or disruptions in any part of the heart can lead to a compromised functioning ability of the entire cardiovascular system.

During every heartbeat, the both the atria contract allows blood to pump into the ventricles. When the ventricles contract, the blood flows into the arteries. There are valves present between the atria and ventricles as well as between the ventricles and the large arteries that comes out of the heart. These valves ensure the one-way flow of blood into the heart.

There are four valves in the heart, the tricuspid, pulmonary, mitral and the aortic valve. Each of these valves has tissue flaps that open and close when the heart beats. The tissue flaps ensure the blood flows only in one direction and there is no backflow. Thus, ensuring the heart continues to beat normally.

In some cases, age-related illnesses and wear and tear, infections, congenital birth defects as well as other conditions, affect the heart valves. The valves then fail to open fully or or allows blood to leak back in the opposite directions. This causes the heart to work harder to pump harder, leading to many health symptoms.

We shall see more about mitral valve prolapse, a heart valve disorder in the following paragraphs.

What is Mitral Valve Prolapse?

The mitral valve is present between the left atrium and the left ventricle. It is the first valve situated on the left side of the heart. It consists of two thin tissue leaflets. These leaflets open and allows blood from the left atrium to flow into the left ventricle. It closes back to prevent a back flow of blood from the left ventricle into the left atrium.                                

Mitral valve prolapse is a condition that causes the valve leaflets to bulge into the left atrium when the left ventricle contracts. The bulge prevents the leaflets from closing properly and forming a tight seal. This sometimes leads to regurgitation or leakage of blood into the atrium.

Mitral valve prolapse is, in some cases, due to a hereditary weakness of the valve tissue. It does not lead to any symptoms in     most people, but can lead to chest pain, migraine headaches, fatigue, dizziness, etc. in some people. The characteristic clicking sound of the heartbeat when heard through the stethoscope, is often used to diagnose the condition. In case of regurgitation, the crisp mid-systolic click heard with the stethoscope is followed by a late systolic murmur.

Symptoms of Mitral Valve Prolapse

Mitral valve prolapse may not lead to regurgitation. In some cases, it may lead to a mild leak to a floppy valve that leaks, depending on the severity of the disease. Some people may never show any symptoms of mitral valve prolapse. Symptoms, if exhibited are as follows:

  • Heart palpitations
  • Chest discomfort
  • Fatigue
  • Anxiety
  • Dizziness
  • Shortness of breath, especially when carrying out any physical activity or lying down flat
  • Chest pain that is not caused by any other coronary heart disease or heart attack

Causes of Mitral Valve Prolapse

The exact cause of mitral valve prolapse is still unknown.In most cases, it occurs as a congenital heart defect. These defects include too thick, big or stretchable mitral valve leaflets. It is also common in people who suffer from connective tissue disorders like Marfan syndrome. Other conditions that may lead to mitral valve prolapse includes scoliosis, adult polycystic kidney disease, Ehlers-Danlos syndrome, polyarteritis nodosa, osteogenesis imperfect, etc.

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Mitral valve prolapse is often caused by myxomatous degeneration. In this condition, the fibrous collagen layer of the valve becomes thin and leads to accumulation of mucoid (myxomatous) material. The valve leaflets tend to enlarge and become rubbery. The chordae turns longer and thinner than normal. This leads to floppy valve leaflets that bulge into the left atrium after the left ventricle contracts. When a degenerated chorda ruptures, it causes the leaflet to swing into the atrium leading to severe regurgitation.

Underlying conditions that make one susceptible to mitral valve prolapse includes Graves disease, hypomastia, sickle cell disease, von Willebrand syndrome as well as rheumatic heart disease.

Diagnosis of Mitral Valve Prolapse

Diagnosis of the mitral valve is usually done during a routine physical examination. The click-murmur sound heard with the stethoscope, helps the doctor suspect mitral valve prolapse. This sound occurs when the valve leaflets fall back into the left atrium with every heartbeat.

Other diagnostic tests for confirming mitral valve prolapse include:

  • Echocardiography
  • Cardiac catheterization
  • Transesophageal echocardiography
  • Radionuclide scans
  • MRI

Treatment of Mitral Valve Prolapse

Mitral valve prolapse treatment usually involves prevention of infective endocarditis and yearly follow-up with the treating doctor. Patients showing symptoms of dysautonomia are prescribed beta-blockers. Those with a medical history of stroke or atrial fibrillation are given aspirin or warfarin. Only 10 to 15% cases of mitral valve prolapse requires valve surgery.

In most cases, mitral valve prolapse does not lead to any symptoms or complications. The affected person continues to live normal life without being even aware of the condition. Only a few require medications to resolve certain symptoms. And in rare cases, heart valve surgery is carried out to solve the problem. Ask any question related to mitral valve prolapse to your doctorand follow his/her advice related to your condition.

Written by: Saptakee sengupta
Date last updated: April 07, 2015

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