Mitral valve prolapse (MVP)

Mitral valve prolapse (MVP) is a bending backwards of the mitral valve as the heart contracts. It is quite a common condition and usually does not cause much problems. One or more valve leaflets bend backwards into the left atrium, mostly because the leaflets are elongated and floppy. It has been named Barlow syndrome as well as many other names like click murmur syndrome. Often it is seen in lean individuals. That does not mean that you should put on weight to avoid MVP!

What problem does an MVP cause?

Mild cases can be totally asymptomatic and detected on routine check up. If the prolapse is too much, the valve can be leaky (mitral regurgitation). Occasionally the leak can be severe to produce symptoms. They can have undue awareness of heart beats (palpitation). Very often the palpitation in MVP is due to anxiety, which is very common in these individuals. Sometimes palpitations could also be due to an abnormal heart rhythm (cardiac arrhythmia). Chest pain is a common symptom in those with MVP though it is not due to a heart attack or an impending heart attack. The chest pain in MVP has features different from that of a heart attack. Very rarely the abnormal valve can get infected (infective endocarditis), which could be a serious problem if not treated early.

Can MVP be treated?

Most often no treatment is required as there is either no leak of the mitral valve or there is only a mild leak. Symptoms in such persons are usually due to anxiety which may need tackling and reassurance. Prompt treatment of any infection and good hygiene is advised to avoid infective endocarditis.

Those with moderate leaks need to be followed up more frequently with ultrasound examination of the heart (echocardiography) to check for progression of disease. Severe leaks can be surgically repaired (mitral valve repair). Those valves which cannot be repaired can be replaced by either a mechanical artificial valve (mechanical prosthetic valve) or a biological artificial valve (bioprosthetic valve).