Mitral valve prolapse

Revision as of 00:38, 5 March 2015 by Neil.m.young (talk | contribs) (format)

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.