Understanding Mitral Valve Prolapse

By Jeremy R. McGarvey, M.D., F.A.C.S.

Mitral valve prolapse is a common heart valve condition affecting approximately 2% of Americans. For many, the condition is not considered dangerous but does need to be monitored by a physician. When severe, an intervention may be needed to correct the problem.

What Is the Mitral Valve?

The mitral valve is an important valve in the heart that separates the left ventricle (the main pumping chamber of the heart) from the lungs. Regurgitation, or leakage through this valve, is relatively common and results from the valve’s two leaflets not closing properly for a perfect seal.

The most common cause of regurgitation is mitral valve prolapse, where one or both of the leaflets bulge (prolapse) upward into the left atrium. This is often a result of the valve stretching, or a tear in the support structures that attach the valve to the underlying left ventricle.

Symptoms of Mitral Valve Prolapse

Many people show no symptoms of mitral valve prolapse and only learn of the condition when their doctor detects a heart murmur during a routine physical exam. However, some people may experience:

• Fatigue

• Shortness of breath with activity

• Difficulty lying flat

• Irregular heart rhythms

• Leg swelling

Mitral Valve Prolapse Treatment

Initially, cardiologists often treat mitral valve prolapse

with diuretics, blood pressure medications, or blood thinners for irregular heart rhythms. If the regurgitation is severe, cardiologists may recommend a surgical procedure.

Surgical Repair of the Mitral Valve

In otherwise healthy individuals, mitral valve surgery is an option with an excellent safety record and results. For most patients, their own mitral valve can be repaired using minimally invasive techniques.

A minority of people must have the valve replaced with a bioprosthetic (cow or pig) or a mechanical valve. People at high risk for surgery can undergo a less invasive, catheter-based option called MitraClip, offered at Penn Medicine Lancaster General Hospital.

Staying Healthy with Mitral Valve Prolapse

Most people with mitral valve prolapse live normal lives. To help prevent complications:

• Don’t smoke.

• Eat a heart-healthy diet and exercise regularly (after consulting your family doctor). • Take prescribed medications as directed.

• Keep all scheduled physical exams and notify your doctor if you notice cold and flu symptoms like sore throat, achiness, and fever. This could signal endocarditis, a bacterial infection that affects the lining of the heart valves. • Maintain good oral hygiene, which can reduce the risk of endocarditis.

Jeremy R. McGarvey, M.D., F.A.C.S., is a cardiovascular surgeon with Lancaster General Health Physicians Cardiothoracic Surgery and a clinical assistant professor of surgery at the University of Pennsylvania Perelman School of Medicine. Dr. McGarvey is a graduate of the University of Pittsburgh School of Medicine. He completed his general surgery residency at the Hospital of the University of Pennsylvania, a research fellowship at the Gorman Cardiovascular Research, and a cardiothoracic fellowship at the Hospital of the University of Pennsylvania.