Heart Valve Alteration: Mitral Valve Prolapse Syndrome

By Cristiano Antonino On Mar 14, 2023

Mitral valve prolapse syndrome is a condition characterised by the alteration of one of the heart valves, the mitral valve

When the heart is functioning properly, the mitral valve will close completely during contraction of the left ventricle, preventing blood from flowing back into the left atrium.

In those suffering from mitral prolapse, one or both valve leaflets will flutter into the left atrium when the left ventricle contracts, preventing the valve from closing.

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What is mitral valve prolapse syndrome?

Normally, the mitral valve consists of two thin movable leaflets anchored by chordae tendineae to the papillary muscles that contract together with the left ventricle where they are located and prevent the mitral leaflets from flaring in the left atrium.

The edges of the flaps separate when the valve opens, allowing blood to flow from the left atrium into the left ventricle; they come together again when the valve closes, preventing blood from flowing back.

Mitral valve prolapse is the flaring into the left atrium of one or both mitral valve leaflets when the left ventricle contracts.

This valve defect occurs in approximately 6% of the population, and women are most affected.

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The causes of mitral valve prolapse syndrome

Mitral valve prolapse will be in the primary form when there is connective tissue disease at the origin, and there will be exuberance of tissue in the valve leaflets.

There will be secondary forms when the prolapse is caused by problems affecting the heart, including: ischaemic heart disease, endocarditis, interatrial defect, hypertrophic obstructive cardiomyopathy, tumour forms.

Symptoms of mitral valve prolapse

In most cases, mitral valve prolapse syndrome will be asymptomatic; symptoms will include prolonged retrosternal pain, heart palpitation and syncope.

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Mitral valve prolapse prevention

Preventing mitral valve prolapse syndrome is not possible, but it is possible to reduce the likelihood of developing related complications; certain pharmacological treatments must be followed.

Diagnosis

Being an asymptomatic valvulopathy, the diagnosis is occasional and will be suggested by cardiac auscultation, a click will be detected followed by a heart murmur.

An ECG will then be performed, which will usually be normal but may show arrhythmias.

With the echocardiogram it will be possible to visualise the movements of the mitral leaflets allowing an accurate assessment of the extent of the prolapse and its mechanisms.

The dynamic ECG according to Holter, will be indicated in subjects reporting palpitations for the evaluation of possible arrhythmias.

Exercise testing is indicated in subjects suffering from syncope and experiencing chest pain.

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