Doctors wear stethoscopes for a reason. Every once in a while, a patient's heart tells a story you can't hear any other way. Lub. Click. Whoosh. Dub. That extra click and whoosh may be a sign of mitral valve prolapse, an extremely common heart condition. But if your heart is making these sounds, don't panic. Mitral valve prolapse (MVP) is almost always harmless. You can still have a long, active life -- with a little background music.
What is mitral valve prolapse?
Your heart has four chambers, two chambers called "atria" on the top half and two powerful chambers called "ventricles" at the bottom half of the heart. When your heart relaxes between beats, blood flows from the left atrium to the left ventricle through a passageway called the mitral valve. The valve has two flaps that swing like doors to let the blood pass through. Normally, these flaps close tightly when your heart beats, so the blood can flow in only one direction, never backwards from the ventricle to the atrium.
If you have mitral valve prolapse, one or both of these flaps is extra floppy and won't close properly. When your heart beats, blood presses against the flap until the flap bulges into the atrium. This makes a clicking noise when heard through a stethoscope. Some of the blood may even leak back into the atrium, causing a whooshing sound, or "murmur."
About 15 million Americans, mostly women, have mitral valve prolapse. The condition is usually inherited and present at birth, although it typically goes undiagnosed for decades.
What are the symptoms of mitral valve prolapse?
More than half of all people with mitral valve prolapse never have any symptoms. If it weren't for those strange sounds heard in the stethoscope, the problem would be completely undetected. For others, possible signs of mitral valve prolapse include a racing heartbeat, irregular beats (especially when lying on the left side), off-and-on chest pain, fatigue, weakness, feelings of anxiety or panic, dizziness, and shortness of breath. Symptoms may be most noticeable during times of stress.
Is mitral valve prolapse dangerous?
The symptoms of mitral valve prolapse can be annoying, but only two out of every 100 people who have it ever suffer any real threat to their health from it. The most common complication is bacterial endocarditis, an infection of the heart. Left untreated, this condition can cause heart failure and even death.
If large amounts of blood flow backwards into the atrium, the heart may become enlarged. In rare cases, this can lead to heart failure.
How is mitral valve prolapse treated?
In most people, mitral valve prolapse doesn't need to be treated at all. If your symptoms are bothersome, your doctor can prescribe certain drugs to make you feel better. Some researchers have also suggested the people with MVP should add a little more salt to their diet. In very rare cases, a surgeon may need to repair the valve to prevent or treat heart failure.
To avoid bacterial endocarditis, you may need to take antibiotics before certain dental or medical procedures. If you don't have a murmur -- in other words, if blood isn't leaking to your atrium -- your risk of endocarditis is probably extremely low. Ask your doctor if antibiotics are necessary in your case.
Most patients with mitral valve prolapse can exercise just as hard and as long as they want. In fact, regular exercise can help your heart work better and ease your symptoms. But if your left ventricle is larger than it should be or if your heart races uncontrollably, you may not be able to play high-intensity sports. Ask your doctor if you need to take any special precautions. By following those recommendations, you won't need to worry about an occasional murmur.
Facts about Mitral-Valve Prolapse. National Heart,Lung, and Blood Institute, National Institutes of Health. www.nhlbi.nih.gov/health/public/heart/other/mvp/mvp-fs.htm
Joy, Alizabeth et al. Mitral Valve Prolapse in Active Patients: Recognition, Treatment, and Exercise Recommendations. The Physician and Sportsmedicine, July 1996.
Mitral Valve Prolapse and Athletic Participation in Children and Adolescents, Policy Statement. American Academy of Pediatrics, May 1995, p. 789-790.
Mitral Valve and Mitral Valve Prolapse, The American Heart Association. www.americanheart.org