Mitral Valve Prolapse

Aka: Mitral Valve Prolapse, MVP

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II. Epidemiology

  1. Incidence: 2.4%

III. Pathophysiology

  1. Redundant valve tissue with elongated chordae tendineae

IV. Symptoms

  1. Chest Pain (occurs in 50% of those with MVP)
    1. Prolonged, sharp and non-exertional
    2. May mimic Angina
  2. Vague associated symptoms
    1. Palpitations
    2. Weakness
  3. Red Flags for problems associated with MVP
    1. Exertional Syncope
    2. Family History of Sudden Cardiac Death
    3. Arrhythmia with Exercise
    4. Marked Mitral Regurgitation

V. Signs

  1. Midsystolic click
    1. Results from sudden tensing of mitral valve
    2. Occurs as leaflets prolapse into left atrium
  2. Systolic Murmur
    1. Late systolic or holosystolic murmur
    2. Murmur prolonged with Valsalva
    3. Murmur decreased with squatting
  3. Timing of click and murmur
    1. Decreased end-diastolic volume (Standing)
      1. Click and murmur start just after S1 Heart Sound
    2. Increased end-diastolic volume (Squatting)
      1. Click and murmur start closer to S2 Heart Sound

VI. Diagnosis

  1. Electrocardiogram often abnormal
    1. Inverted T Waves in leads II, III, and AVF
  2. Holter Monitor
    1. Variety of Dysrhythmias
  3. Echocardiogram
    1. Mitral Valve Prolapse is a common echo finding
    2. New criteria based on three dimensional valve shape

VII. Management

  1. Reassurance
    1. Low Incidence of serious complications
  2. Symptomatic treatment
    1. Indications
      1. Chest Pain
      2. Palpitations
      3. Anxiety
    2. Medications
      1. Beta Blockers
  3. General measures
    1. Alcohol cessation
    2. Tobacco Cessation
    3. Caffeine cessation
  4. SBE Prophylaxis
    1. Indicated only if Mitral Regurgitation present

VIII. References

  1. Kondos (1998) CMEA Medicine Review Lecture, San Diego
  2. Assi (1998) Postgrad Med 104(6):99-110 [PubMed]
  3. Bonow (1998) Circulation 98:1949-84 [PubMed]
  4. Carabello (1997) N Engl J Med 337(1):32-41 [PubMed]
  5. Joy (1996) Physician and Sportsmed 24(7):78-86
  6. Shipton (2001) Am Fam Physician 63(11):2201-8 [PubMed]

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Related Studies

Ontology: Mitral Valve Prolapse Syndrome (C0026267)

Definition (MEDLINEPLUS)

Mitral valve prolapse (MVP) occurs when one of your heart's valves doesn't work properly. The flaps of the valve are "floppy" and don't close tightly. Most people who have the condition are born with it. It also tends to run in families.

Most of the time, MVP doesn't cause any problems. Rarely, blood can leak the wrong way through the floppy valve. This can cause

  • Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or too fast)
  • Shortness of breath
  • Cough
  • Fatigue, dizziness, or anxiety
  • Migraine headaches
  • Chest discomfort

Most people who have mitral valve prolapse (MVP) don't need treatment because they don't have symptoms and complications. If you need treatment for MVP, medicines can help relieve symptoms or prevent complications. Very few people will need surgery to repair or replace the mitral valve.

MVP puts you at risk for infective endocarditis, a kind of heart infection. To prevent it, doctors used to prescribe antibiotics before dental work or certain surgeries. Now, only people at high risk of endocarditis need the antibiotics.

NIH: National Heart, Lung, and Blood Institute
Definition (NCI) A fairly common and often benign valvular heart disorder characterized by redundancy or hooding of mitral valve leaflets so that they prolapse into the left atrium, often causing mitral regurgitation. It is often a symptomless condition but may be marked by varied symptoms (e.g. chest pain, fatigue, dizziness, dyspnea, or palpitations) leading in some cases to endocarditis or ventricular tachycardia.
Definition (NCI_FDA) Prolapse of the mitral valve, often with regurgitation, associated with myxomatous proliferation of the leaflets of the mitral valve.
Definition (MSH) Abnormal protrusion or billowing of one or both of the leaflets of MITRAL VALVE into the LEFT ATRIUM during SYSTOLE. This allows the backflow of blood into left atrium leading to MITRAL VALVE INSUFFICIENCY; SYSTOLIC MURMURS; or CARDIAC ARRHYTHMIA.
Concepts Disease or Syndrome (T047)
MSH D008945
ICD10 I34.1
SnomedCT 8074002, 42069006, 194980008, 45023003, 194977007, 155386005, 409712001
English Click-Murmur Syndrome, Mitral, Click-Murmur Syndrome, Systolic, Floppy Mitral Valve, Floppy Mitral Valves, Mitral Click Murmur Syndrome, Mitral Click-Murmur Syndrome, Mitral Valve Prolapse, Mitral Valve Prolapses, Mitral Valve, Floppy, Mitral Valves, Floppy, Prolapses, Mitral Valve, Syndrome, Mitral Click-Murmur, Systolic Click Murmur Syndrome, Systolic Click-Murmur Syndrome, Valve Prolapse, Mitral, Valve Prolapses, Mitral, Prolapse, Mitral Valve, Syndrome, Systolic Click-Murmur, Floppy mitral valve, Mitr valve prolap, post leaf, Mitral regurg cusp prolapse, Mitral regurgitation due to cusp prolapse, Mitral valve post leaf prolaps, Mitral (valve) prolapse, MYXOMATOUS VALVULAR DISEASE, FAMILIAL, NEUROCIRCULATORY ASTHENIA, MITRAL VALVE PROLAPSE, FAMILIAL, PMV, ORTHOSTATIC INTOLERANCE, PROLAPSED MITRAL VALVE, MITRAL REGURGITATION, FAMILIAL, FLOPPY MITRAL VALVE, CLICK-MURMUR SYNDROME, MITRAL VALVE PROLAPSE SYNDROME, MVP, Mitral leaflet prolapse, Prolapsed mitral valve, J.B. Barlow syndrome, Mitral Valve Prolapse [Disease/Finding], Mitral Valve Prolapse Syndrome, click-murmur syndrome, floppy mitral valve, mvp, click syndrome, Prolapse;mitral valve, mitral valve prolapse (MVP), mitral valve prolapse syndrome, barlow's syndrome, floppy valve syndrome, Syndromes, Click-Murmur, Prolapsed Mitral Valve, Click-Murmur Syndrome, Prolapsed Mitral Valves, Click Murmur Syndrome, Valves, Prolapsed Mitral, Mitral Valve, Prolapsed, Valve, Prolapsed Mitral, Mitral Valves, Prolapsed, Click-Murmur Syndromes, Syndrome, Click-Murmur, Mitral prolapse, Mitral valve prolapsed, mitral valve prolapse (diagnosis), J.B. Barlow's syndrome (diagnosis), mitral valve prolapse cusp j.b. barlow's syndrome, MITRAL VALVE PROLAPSE, PROLAPSE, MITRAL VALVE, VALVE, PROLAPSE OF MITRAL, Barlow's syndrome, Click syndrome, Asynchronous valve closure syndrome, J.B. Barlow's syndrome, Mitral valve posterior leaflet prolapse, Mitral valve prolapse, posterior leaflet, Click-murmur syndrome, Floppy valve syndrome, J.B. Barlow's syndrome (disorder), Mitral valve prolapse syndrome, floppy mitral valve syndrome, floppy; syndrome, mitral valve, mitral valve; floppy, mitral; floppy mitral valve syndrome, mitral; prolapse, prolapse; mitral, syndrome; floppy mitral valve syndrome, syndrome; floppy, mitral valve, Mitral valve prolapse, MVP - Mitral valve prolapse, Mitral valve prolapse (disorder), mitral valve prolapse
Dutch slappe mitralisklep, floppy; syndroom, mitral valve, mitraal; floppy mitral valve syndrome, mitraal; prolaps, mitraalklep; slap, prolaps; mitraal, syndroom; floppy mitral valve syndrome, syndroom; floppy, mitral valve, Mitralis(klep)prolaps, mitralisklepprolaps, Floppy mitral valve, Mitralis-clicksyndroom, Mitralisklepprolaps, Prolaps, mitralisklep-, Systolische-clicksyndroom
French Ballonnement de la valve mitrale, Valve mitrale prolabée, Prolapsus de la petite valve de la mitrale, Prolapsus valvulaire mitral, Prolapsus de la valvule mitrale, Prolapsus de la valve mitrale, Prolapsus mitral
German schlaffe Mitralklappe, Mitralsegelprolaps, Floppy-Valve-Syndrom, Mitralklappenprolaps
Italian Prolasso di cuspide della valvola mitralica, Prolasso valvolare mitralico, Valvola mitrale prolassata, Sindrome del click-soffio cardiaco, Sindrome da prolasso valvolare mitralico, Prolasso della valvola mitralica, Prolasso della valvola mitrale
Portuguese Válvula mitral flácida, Prolapso de valva mitral, Válvula mitral prolapsada, Prolapso da válvula mitral, Prolapso da Valva Mitral, Síndrome do Click da Valva Mitral, Síndrome do Click Sistólico
Spanish Válvula mitral caída, Válvula mitral prolapsada, Prolapso de válva mitral, prolapso mitral, Prolapso Mitral, síndrome de J.B. Barlow (trastorno), síndrome de J.B. Barlow, síndrome del cierre valvular asincrónico, Prolapso de la válvula mitral, prolapso de la válvula mitral (trastorno), prolapso de la válvula mitral, Prolapso de la Válvula Mitral, Síndrome del Chasquido-Soplo Mitral, Síndrome del Chasquido-Soplo Sistólico, Válvula Mitral Floja
Japanese 僧帽弁尖逸脱, 逸脱性僧帽弁, ｲﾂﾀﾞﾂｾｲｿｳﾎﾞｳﾍﾞﾝ, ｿｳﾎﾞｳﾍﾞﾝｲﾂﾀﾞﾂ, ｿｳﾎﾞｳﾍﾞﾝｾﾝｲﾂﾀﾞﾂ, 僧帽弁逸脱, 収縮期クリック雑音症候群, はばたき僧帽弁, 僧帽弁クリック雑音症候群, 僧帽弁脱, フロッピーバルブ症候群
Swedish Mitralklaffprolaps
Czech mitrální chlopeň - prolaps, Prolaps mitrální chlopně, Prolabující mitrální chlopeň, Prolaps cípu mitrální chlopně
Finnish Hiippaläpän prolapsi
Russian SISTOLICHESKOGO SHCHELCHKA I SHUMA SINDROM, MITRAL'NOGO SHCHELCHKA I SHUMA SINDROM, SVOBODNO VISIASHCHEGO MITRAL'NOGO KLAPANA SINDROM, MITRAL'NOGO KLAPANA PROLAPS, МИТРАЛЬНОГО КЛАПАНА ПРОЛАПС, МИТРАЛЬНОГО ЩЕЛЧКА И ШУМА СИНДРОМ, СВОБОДНО ВИСЯЩЕГО МИТРАЛЬНОГО КЛАПАНА СИНДРОМ, СИСТОЛИЧЕСКОГО ЩЕЛЧКА И ШУМА СИНДРОМ
Korean 승모(판) 탈출
Croatian MITRALNI PROLAPS
Hungarian Mitralis prolabált billentyű, Mitralis mobilis billentyű, Mitralis billentyű prolapsus, Mitralis prolapsus
Polish Wypadanie płatka zastawki mitralnej
Norwegian Mitralklaffprolaps
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Valvular Disease

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