17241 Mitral Valve Prolapse

Overview

The mitral valve is one of the four valves in your heart. It has two flaps that open and close to keep blood moving in the right direction. In mitral valve prolapse, one or both flaps bulge backward into the left upper chamber of the heart when the heart squeezes. For most people, this is a harmless change and does not need treatment.

Mitral valve prolapse is fairly common. It is thought to affect about 1 in 50 to 1 in 100 people. Many who have it never know, because it often causes no problems.

It can affect people of any age. It is often found in teenagers or young adults during a routine check-up. It may run in families and is more common in people with certain connective tissue conditions.

Symptoms

Common symptoms

• No symptoms at all
• Palpitations: feeling like your heart is fluttering, racing, or skipping a beat
• Chest discomfort that is not always related to activity
• Shortness of breath during activity or when lying flat
• Fatigue or feeling unusually tired
• Dizziness or light-headedness

Symptoms in children

• Usually no symptoms
• Some children feel occasional palpitations
• Some children get tired more easily during sports

Symptoms in older adults

• Shortness of breath with everyday activity
• Swelling in the ankles or feet
• Palpitations that become more frequent
• Feeling more tired or breathless when exercising

Causes

Main causes

• The mitral valve is slightly floppy, so its flaps bulge backward when the heart beats.
• The connective tissue in the valve is weaker than usual.
• It can be inherited, meaning it runs in families.

Risk factors

• A family history of mitral valve prolapse
• Connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome
• Being born with differences in the shape of the chest or spine, such as scoliosis

When to see a doctor

See a doctor urgently if:

• If you faint, have severe chest pain, or cannot breathe properly, call your local emergency number right away.
• If your heart races and you feel dizzy or pass out, seek urgent medical help immediately.

Book a routine appointment if:

• Make an appointment if you notice palpitations that bother you, new chest discomfort, or unusual shortness of breath.
• See your doctor if you feel extremely tired or short of breath when doing activities that used to be easy.

Diagnosis

Mitral valve prolapse is often found during a routine check-up when your doctor listens to your heart with a stethoscope. They may hear a click or a soft murmur. A simple, painless ultrasound scan of the heart, called an echocardiogram, is used to confirm the diagnosis.

Tests that may be done

• Echocardiogram: an ultrasound picture of your heart and valves
• Electrocardiogram (ECG): a test that records the heart's electrical activity
• Ambulatory heart monitor: a wearable device that tracks your heart rhythm over 24 to 48 hours
• Sometimes an exercise stress test to see how your heart behaves during activity

What to expect at your appointment

Your doctor will ask about your symptoms and medical history, then examine you. The tests are painless and usually done in a clinic or hospital. Most people can go home the same day and get back to normal activities right away.

Treatment

Most people with mitral valve prolapse do not need any treatment. If the valve leaks significantly or symptoms are troublesome, treatment focuses on reducing symptoms and protecting the heart over time. Your doctor will decide the right approach based on how leaky the valve is, your symptoms, and how well your heart is working.

Self-care at home

• Keep up with regular check-ups with your GP or heart specialist.
• Stay well hydrated, and ask your doctor how much fluid is right for you.
• Limit caffeine and alcohol if they seem to trigger palpitations.
• Learn simple breathing exercises or relaxation methods to manage stress.
• Tell your doctor about any new symptoms, such as breathlessness or chest pain.

Medical treatments

If symptoms are bothersome, your doctor may suggest medications to slow or steady the heart rhythm, lower blood pressure, or reduce palpitations. These are prescribed only when needed and always under a doctor's care. Some people with a higher risk of heart infection may need antibiotics before certain dental or surgical procedures. Always ask your healthcare team whether you need them.

When is surgery considered?

Surgery is not needed for most people with mitral valve prolapse. If the valve becomes severely leaky and the heart is working too hard, a surgeon may repair or replace the valve. Modern valve surgery has very good results, and this option is discussed only when the benefits clearly outweigh the risks.

Living with this condition

Living with mitral valve prolapse usually means living normally. Most people can work, study, travel, and stay active. Keep your healthcare appointments and let your doctor know if your symptoms change.

Lifestyle tips

• Stay active in a way that feels comfortable; exercise is safe for most people.
• Do not smoke and avoid recreational drugs.
• Limit alcohol and caffeine if they make symptoms worse.
• Find a relaxation practice that helps you feel calm and in control.

Diet and exercise

Eat a heart-healthy diet rich in vegetables, fruit, whole grains, and lean proteins. For most people, moderate exercise like walking, cycling, or swimming is safe and beneficial. Ask your doctor if there are any activity restrictions based on your specific valve condition.

Mental health and emotional wellbeing

Some people with mitral valve prolapse feel anxious, especially when they notice palpitations. Understanding that MVP is usually a harmless finding can help ease fear. If anxiety is affecting your daily life, talk to your GP or a mental health professional. If you ever feel overwhelmed and have thoughts of harming yourself, reach out for help immediately by calling your local emergency number or crisis helpline.

Prevention

Mitral valve prolapse cannot always be prevented, because it is often a structural feature you are born with. However, you can reduce the chance of complications by keeping your heart healthy and attending regular check-ups.

Vaccines

Keep your routine vaccinations up to date, including flu, COVID-19, and any vaccines recommended by your local health service. This helps protect you from infections that could affect your heart.

Screening programmes

If you have a family history of mitral valve prolapse or a connective tissue disorder, talk to your doctor about whether an echocardiogram is useful. Most people do not need screening unless they have symptoms or a strong family history.

Complications

If left untreated

• Worsening of mitral regurgitation, where blood leaks backward through the valve
• Irregular heart rhythms, called arrhythmias, which may cause palpitations or dizziness
• Rarely, infection of the heart valve, known as infective endocarditis
• In severe cases, heart failure if significant leakage is not managed

Long-term outlook

For most people, mitral valve prolapse is a harmless condition that does not change life expectancy. Even when treatment is needed, modern care gives very good results. Many people with MVP live full, active lives and need little or no treatment.

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