Mitral Valve Prolapse
(Click Murmur, Floppy Valve, or Balloon Mitral Syndrome)
Mitral valve prolapse is a minor heart defect that prevents the valve linking the two left chambers -- the atrium and ventricle -- from closing properly. After blood receives fresh oxygen in the lungs, it passes into the left atrium, through the mitral valve (shaped like a bishop's miter), into the left ventricle, which pumps it out of the heart into the aorta. In mitral valve prolapse, one or both leaflets -- the flaps that open and close to form the valve -- bulge into the atrium during each heartbeat, and a little blood heading for the ventricle may leak (regurgitate) back into the atrium.
In most people, this is a harmless, symptomless condition. When symptoms do occur, they usually take the form of palpitations, fatigue, shortness of breath, chest pains, dizziness, and a tendency to faint. Stress appears to bring on or exacerbate these problems.
Serious complications are rare, but mitral valve prolapse can increase dot formation, leading to a stroke. People with this condition are also at greater risk of endocarditis, an infection of the membrane that lines the heart and its valves. And the condition can set the stage for serious disturbances in the heart's normal rhythm, especially ventricular tachycardia, which may lead to sudden death. In rare cases, the valve may rupture, which is also fatal.
In the past, mitral valve prolapse was considered primarily a congenital disorder of women. However, research shows that men and women are about equally affected.
Diagnostic Tests and Procedures
A characteristic clicking sound heard through a stethoscope placed over the left side of the heart and the back tips off a doctor to the possibility of mitral valve prolapse. Tests include an electrocardiogram and chest X-ray; an echocardiogram revealing abnormal mitral leaflets gives a definitive diagnosis.
Medical Treatments
Mitral valve prolapse seldom requires treatment, but periodic heart checkups are advisable because the degree of prolapse can progress with age.
Drug Therapy. Frequent palpitations and chest pain can be treated with low doses of a beta-blocking drug such as propranolol (Inderal) to slow the heart rate. If the heart is unable to pump sufficient blood, other drugs can be prescribed to make it beat more forcefully.
Because any valve abnormality carries an increased risk of endocarditis, prophylactic antibiotics should be taken before any dental procedure or surgery that involves bleeding and a risk that bacteria may invade the bloodstream and be carried to the heart.
Surgery. In unusual cases, the mitral valve becomes so diseased that it allows blood to back up into the lungs. When this happens, the defective valve can be replaced with an artificial one.
Alternative Therapies
Exercise Conditioning. A program of gradual exercise conditioning can improve stamina and alleviate fatigue.
Yoga and Meditation. Because stress can provoke symptoms, these and other relaxation techniques are often recommended to counteract it.
Self-Treatment
Many people with mitral valve prolapse experience orthostatic hypotension -- brief periods of dizziness and faint ness when getting out of bed or rising from a chair. This can be prevented by avoiding sudden changes in position. For example, when you arise in the morning, slowly sit up and let your feet dangle over the side of the bed for a minute before standing. When getting out of a chair, sit forward with your feet on the floor for a few seconds, then stand up slowly.
You may be advised to avoid any strenuous activities that place particular strain on the heart, especially if yous have severe symptoms.
Other Causes of Cardiac Symptoms
Other types of heart valve disease, angina, and congestive heart failure can cause symptoms similar to those or mitral valve prolapse, as can panic attacks.