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 disorder

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

Evaluation

  • Echocardiogram
  • ECG can show nonspecific changes or arrhythmias
  • CXR usually normal

Differential Diagnosis

Valvular Emergencies

Management

  • Aymptomatic
    • None
  • Symptoms of autonomic dysfunction
  • Signs of progression to MR
    • Early surgical repair
  • Neuro sequelae
  • Click / Murmur

Complications

References


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