Mitral valve prolapse

Overview

Mitral valve prolapse is a condition where one of the heart’s valves — the mitral valve — doesn’t close tightly. Think of it like a door that bulges slightly when it should be shut. In most people, this is harmless and causes no problems, but in some it can lead to symptoms or complications.

Yes, mitral valve prolapse is quite common. It affects about 2 to 3 out of every 100 people. It is the most common heart valve abnormality.

It can affect people of any age, but it is most often found in young to middle-aged adults. It is more common in women than in men.

Symptoms

Common symptoms

• Most people have no symptoms at all.
• Some people feel heart palpitations — a fluttering or rapid heartbeat.
• Others may have chest pain that is not related to a heart attack.
• Shortness of breath, especially when lying down or exercising.
• Fatigue or feeling tired even after light activity.
• Dizziness or lightheadedness.

Symptoms in children

• Children with mitral valve prolapse often have no symptoms.
• If symptoms occur, they may include feeling the heart race or skip a beat.
• Some children may complain of chest discomfort or feeling tired easily.

Symptoms in older adults

• Older adults may have more noticeable symptoms if the valve worsens over time.
• They might experience shortness of breath during everyday activities.
• Palpitations and fatigue can become more frequent.

Causes

Main causes

• The exact cause is not always known. It often involves changes in the tissue of the mitral valve that make it floppy or stretchy.
• Some people are born with a slightly different valve structure.
• In rare cases, it can be linked to other conditions like connective tissue disorders (for example, Marfan syndrome).

Risk factors

• Family history of mitral valve prolapse or other heart valve problems.
• Being female or assigned female at birth.
• Having certain connective tissue disorders.
• Having scoliosis (curved spine) or other skeletal issues.

When to see a doctor

See a doctor urgently if:

• If you have chest pain, shortness of breath, or feel faint, see a doctor or go to urgent care right away.

Book a routine appointment if:

• If you notice new palpitations, fatigue, or dizziness that doesn’t go away, make an appointment with your healthcare provider.

Diagnosis

A healthcare provider usually diagnoses mitral valve prolapse during a routine exam. They listen to your heart with a stethoscope and may hear a clicking sound or a murmur (whooshing sound) that suggests the valve is not closing properly.

Tests that may be done

• Echocardiogram (echo) — an ultrasound of the heart to see the valve and how it moves.
• Electrocardiogram (ECG or EKG) — a test that records the heart’s electrical activity.
• Chest X-ray in some cases.
• Holter monitor — a portable device worn for 24 hours to track your heart rhythm.

What to expect at your appointment

Diagnosis is straightforward and painless. The echocardiogram is the key test. Your doctor will explain the results and what they mean for your health. Most people do not need further testing unless symptoms develop.

Treatment

For most people with mitral valve prolapse, no treatment is needed. If you have symptoms or complications, treatment focuses on managing those issues and monitoring the valve over time.

Self-care at home

• Stay active and eat a heart-healthy diet.
• Avoid caffeine and other stimulants if they trigger palpitations.
• Drink plenty of water to stay hydrated.
• Get enough rest and manage stress.

Medical treatments

If you have bothersome symptoms like palpitations, your doctor may suggest medications to help control heart rate or reduce chest discomfort. These are always prescribed based on your individual needs and after discussing the risks and benefits.

When is surgery considered?

Surgery is very rarely needed. It is only considered if the valve becomes leaky (regurgitation) severe enough to weaken the heart, or if you develop complications like endocarditis (infection of the valve lining). Your heart team will discuss all options with you.

Living with this condition

Most people with mitral valve prolapse live normal, active lives. You may not need to change anything, but it is a good idea to have regular check-ups with your doctor.

Lifestyle tips

• Let your dentist know you have the condition — you may need antibiotics before certain dental procedures to prevent infection.
• Avoid heavy lifting or straining if your doctor advises.
• Learn to recognize your symptoms so you know when to seek help.

Diet and exercise

A heart-healthy diet with plenty of fruits, vegetables, whole grains, and lean proteins is recommended. Exercise is beneficial, but if you have symptoms, ask your doctor what level of activity is safe for you.

Mental health and emotional wellbeing

Being told you have a heart condition can be worrying, even if it is usually harmless. Anxiety about symptoms like palpitations is common. If you feel stressed or anxious, talk to your doctor or a mental health professional. You are not alone.

Prevention

Mitral valve prolapse cannot be prevented since it is often present from birth. However, you can take care of your heart health with a balanced diet, regular exercise, and avoiding smoking.

Complications

If left untreated

• In rare cases, the valve may leak more blood backward (regurgitation), which can cause the heart to work harder over time.
• Some people with a leaky valve may develop an irregular heartbeat (atrial fibrillation).
• There is a small risk of infective endocarditis — a serious infection of the heart lining — especially after dental procedures or surgeries.

Long-term outlook

For the vast majority of people, mitral valve prolapse is a harmless variation. Even those who develop complications can often be managed well with treatment. With regular check-ups and good heart health, most people lead full, healthy lives.

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