Mitral valve prolapse

Background

• 1 or more mitral valve leaflets bow into left atrium during systole
• Most common valve disease in industrial countries (2.4% of pop.)
• Myxomatous degeneration from connective tissue disorders

Symptoms

• Studies failed to demonstrate that chest pain, anxiety, or palpitations are associated with MVP
• Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance
• If progresses to MR, CHF symptoms

Physical exam

• Mid-systolic click
• Late systolic murmur, crescendo into S2
• Assoc. with pes excavatum, scoliosis, low body weight, Marfanoid

Diagnosis

• Echocardiogram
• ECG, CXR usually normal

Complications

• Stroke
• Endocarditis
• Arrhythmia
• MR

Treatment

• Aymptomatic
  • None
• Symptoms of autonomic dysfxn
  • Beta-blocker
• Signs of progression to MR
  • Early surgical repair
• Neuro sequelae
  • Rule out a-fib / left atrial thrombus, then asa qday
• Click / Murmur
  • Consider endocarditis ppx

Source

• Tintinalli
• Thakar, B. Mitral Valve Prolapse. Medscape 2015.