By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER’S MVP IS COMMON, PROBABLY WON’T AFFECT HIS LIFESTYLE

Question: I went for my annual checkup last week and my doctor told me she thinks I have mitral valve prolapse. She only listened to my heart, and she could tell. I have seen her for several years, so why hasn’t she found it before? She told me there is nothing to do about it and that I should not worry, but I am a worrier. Can you tell me more about this?

Answer: Mitral valve prolapse (MVP) is a relatively common medical condition that occurs when the mitral valve on the left side of your heart doesn’t close properly. This valve is designed to only allow the blood to flow in one direction -- from the upper chamber (atrium) to the lower chamber (ventricle). What happens with MVP, though, is that when the lower chamber contracts to force blood into the aorta -- the body’s largest artery -- the leaflets of the mitral valve bulge, or prolapse, back into the upper chamber. In most cases this prolapsing is not enough to cause blood to flow the wrong way. When it does happen it’s called regurgitation.

About 2 percent of the population has MVP -- divided about equally between men and women. It is usually a lifelong disorder, and in most people there are never any symptoms. As happened in your case, it is commonly diagnosed by a stethoscope exam of the heart. MVP does seem to run in families, and people with connective tissue disorders like Marfan’s syndrome are at increased risk.

When mitral regurgitation occurs, symptoms may need to be treated. Symptoms can include racing heart, shortness of breath, fatigue or chest pain that is not from a heart attack.

If you have symptoms and seek medical care, the doctor may perform an echocardiogram. This is an ultrasound of your heart which shows the motion of the valves and how much regurgitation is present. Mild regurgitation is generally just watched with echocardiograms every few years.
Another complication of MVP is an infection of the heart valve called bacterial endocarditis. This is more common in older people and is treated with antibiotics. Other complications that can occur with this condition include cardiac arrhythmias and irregular heartbeat.

If you have MVP with no symptoms, you do not need any treatment. If you have symptoms with your MVP, then your doctor may prescribe some medications. If you have racing or irregular heartbeat, you may need a beta-blocker type of medication. They help to slow your heart and improve the rhythm. Some people with MVP are advised to take a daily aspirin.

People with MVP who have regurgitation are often advised to take antibiotics for dental work. This can help prevent endocarditis. Check with your doctor or dentist to see if you need to take this safeguard.

Finally, let me stress the positive. Most people with MVP lead normal, full lives with no problems. Since your doctor told you “not to worry,” I would take her advice. You are undoubtedly one of those who have an uncomplicated case of MVP and don’t need to restrict your life in any way. In other words, your lifestyle should be unaffected. Your doctor will monitor you over the years, and if you ever develop any complications, she can make new recommendations at that point.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.