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 disorders
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
Diagnosis
- Echocardiogram
- ECG, CXR usually normal
Complications
- Stroke
- Endocarditis
- Arrhythmia
- MR
Treatment
- Aymptomatic
- None
- Symptoms of autonomic dysfxn
- Beta-blocker
- Signs of progression to MR
- Early surgical repair
- Neuro sequelae
- Rule out a-fib / left atrial thrombus, then asa qday
- Click / Murmur
- Consider endocarditis ppx
Source
- Tintinalli
- Thakar, B. Mitral Valve Prolapse. Medscape 2015.