- Diseases, Disorders & Conditions
What Is Mitral Valve Prolapse
Exploded view of Prolapsed Mitral Valve within the Left Atria of the Heart
When you take a few moments to think about it...the heart itself is a unique piece of anatomical machinery. Magnificent in how it is made, so simple yet so complex. And it is bind-boggling to add-just how many conditions can cause it to malfunction.
The cardiac muscle has four chambers and also four heart related valves. Each individual valve is located within the various heart chambers. They perform the job of pushing blood out of each, and into different parts of the body. They are the aortic, pulmonary, tricuspid and biscuspid or mitral valves. It's interesting to note here, that the mitral valve is the only valve that contains two leaflets. The other three have three leaflets that cover their individual valves respectively.
I will not get into detail about these other valves in this particular article. Rather I will focus more on the Mitral Valve, which tends to present more of an issue with heart related murmurs, than some of the other heart valves do.
Upon looking at the mitral valve, it appears to look like it has two peaks and is somewhat similar in appearance to a Bishop's miter. Mitral Valve Prolapse was first described by John Brereton Barlow in 1966. It is an abnormal bulging outward; of the leaflet that closes over a thickened Bicuspid or Mitral Valve, which protrudes backwards into the left atrium of the heart.
This condition also occurs during contraction or systole of the heart. (MVP) or mitral valve prolapse has also been referred to as "Balloon Mitral Valve, Straight-Back Syndrome, Click-Murmur Syndrome and Barlow's Syndrome."
For the most part MVP or Mitral Valve Prolapse is usually benign in nature and does not often present any real problems. MVP of this type can be considered unclassic in origin. MVP can be more serious and considered classic mainly when infective endocarditis is present with it, mitral regurgitation or congestive heart failure.
And in some cases cardiac arrest, sometimes resulting in sudden death can occur. What makes this syndrome abnormal, is the fact that when the mitral valve closes, after blood is ejected from within; the leaflet covering it does not make a tight seal or close evenly over it.
This results in a back-flow or regurgitation back through this valve and into the upper left atria of the heart. This is not good because a sudden arrhythmia, can occur. When this happens your heart can start beating very rapidly and abruptly. In a worse case scenario a very rapid beating of the heart can occur - called ventricular tachycardia. can develop. Where the heart can actually be quivering rather than pumping blood.
Upon examination by a physician, a clicking sound or murmur is produced. This is the sound that the physician can hear through his or her stethoscope and as briefly mentioned, is produced by the back flow of blood into the atria. Even though the murmur produced by a prolapsed mitral valve can be heard with the Health Care Practitioner's stethoscope, this is not always the case. And if your doctor thinks that you may have MVP Syndrome, they may further suggest that you follow-up with an echocardiogram.
An echocardiogram is a type of sonogram of your heart. It looks deeper into the heart muscle and at the different areas of it including the valves. It is non-invasive which means no type of entry or surgical procedure is required. Any type of abnormalities that are suspected by the physician can often be confirmed with an echocardiogram, but not in all cases.
Symptoms of Mitral Valve Prolapse may be few to none. About 60% of individuals do not even know that they have the disorder, because they never experience...chest pain that arises suddenly for no apparent reason. Migraine headaches and panic attacks are also some of the symptoms that are associated with MVP. On average about (11% to 15%) of patients with MVP do experience shortness of breath and chest pain. these symptoms are often present in men fifty years of age or older.
The symptoms are usually related more so with classic symptoms of the disorder rather than with unclassic ones. Chest pain is one of the main reasons besides anxiety attacks, present with palpitations, that bring a patient suffering with mitral valve prolapse to the emergency room.
Symptoms of MVP do not usually occur before the age of fourteen and studies have shown that about six percent of women have MVP and about two percent of men have the condition. However studies also have shown that as a woman's age increases her incidence of this heart valve disorder decreases which has puzzled some reseacher's as to why this is the case. More recent data also suggests that there is an equal prevalence of (MVP) between men and women. Also the ratio of younger men to older men with mitral valve prolapse is about the same.
Even though the direct cause of Mitral Valve Prolapse is not really known, it is usually associated with another diseases; such as diseases of the heart muscle, coronary artery disease and atrial septal defect which in most instances occurs at birth. Also as mentioned previously in reference to the percentage of patients that do experience symptoms relative to MVP. Forty percent of those individuals also have (ANS) or Autonomic Nervous System Disorder.
Dysautonomia is the term used when this system is out-of-balance or out of synch, if you will. The Parasympathetic and Sympathetic nervous system that coincides with the autonomic nervous system can totally throw the body out of whack. All bodily functions for example...Temperature, blood pressure, digestion, vision, heartbeat and respiration are also controlled by the parasympathetic and sympathetic nervous systems.
And as a result from the aforementioned, some of the symptoms that can arise from these nervous systems being out of synch with each other, are (IBS) or Irritable Bowel Syndrome, Anxiety attacks, fatigue, palpitations and migraine headaches.
Also interesting to note, is that roughly 95% of people with Dysautonomia in combination with Mitral Valve Prolapse-have nothing wrong with their hearts at all. Individuals not born with MVP, usually develop it from some other condition that can account for it. (Scoliosis) or an abnormal curvature of the spine ,is an example of a type of connective tissue disorder that can account as another one of these named conditions.
In addition to the group of patients who do have symptoms related to MVP syndrome, further treatment can be employed to correct rapid and/or abnormal heart rhythms. Beta-Blocker drugs assist with this process by relaxing blood vessels by lowering the blood pressure within the arteries of the heart-in turn letting it beat and pump blood out of the veins and valves on a relatively more normal level.
If still the condition is deemed serious enough in nature, than surgery is an option that can be performed by trimming back the leaflet that covers the mitral valve. By doing so will result in a tighter and more even close over it, preventing backward blood flow from the left ventricle into the upper left atria.
Important to also consider to any surgery here, even it is a minor, outpatient procedure such as a colonstopy, is that the possibility of strep occurring is greater as a result of this or other type of surgical procedure being performed. Individual patients who have an echocardiogram result from their doctor that shows leakage across the mitral valve should be concerned with protecting themselves from (endocarditis), or inflammation of the heart muscle; mitral valve regurgitation and arrhythmia's.
Bacterial infection from minor surgical procedures as noted above can lead to strep. Also having dental work performed that may cause some bleeding, is probably one of the most prevalent ways for strep to develop. However numerous other minor surgical procedures that can cause some bleeding like colonostopies also increase the chances of getting a strep infection.
Antibiotics are used to fight various bacterial infections; because they attack a broad spectrum of different types of bacteria, of which strep is one of. Prior to any surgical procedures an antibiotic is given to an individual to prevent infection of the mitral valve, during surgeries. Two doses are usually given one hour before it, and than again six hours after the procedure.
In patients with abnormal heart palpitations, or even angina pe torus - often referred to chest pain. There are also medications employed, to prevent these problems from occurring as well. In a worse case scenario, mechanical or biological valves, formerly belonging to a pig if it is mechanical in nature, or that of a human if it is biological, are used to replace a defective mitral valve. Even though this is very effective particularly if it is a mechanical valve, because it usually lasts a human lifetime.
On the downside is the fact that individuals with mechanical valves also have to take blood thinners for the rest of their lives. An example of a few of these blood thinner's is either (Warfarin) or Plavix. The purpose of the blood thinner is to prevent platelets from sticking to the inner workings of the valve itself and to prevent malfunction. Biological or human valves tend not to be so long-lasting and usually need replacing every ten years or so.
When you take all of the relative information about mitral valve prolapse into perspective, the overall prognosis for this valvular heart condition is good. And if you look closer at the statistics there are, relatively speaking, only about five percent or less of individuals actually suffer with symptoms in relation to their condition.
Not a large number when you think about it. Further more it is not anyone's fault for having developed a condition like MVP. Don't forget you were either born with it, or inherited it, possibly via genetics at birth. For others it could have once again developed from an underlying previous illness...scarlet fever or scoliosis-which really is not the individuals fault, for having developed it from these causes in the first place.
A few positive points to reflect upon however is that, if you or a loved one does have mitral valve prolapse; it is not really considered a handicap in the sense of what we define a real true handicap to be. It will not prevent you from acquiring gainful employment nor will it prevent you from performing your everyday daily routines.
It is merely a minor condition that medication can correct and if need be, minor surgery can repair, to a valve that may rarely have to be trimmed back or replaced, and I want to emphasize the word rarely here. Also remember that so many more serious conditions can arise that can and do affect our hearts, too numerous to mention.
Those conditions are some of the more serious ones that could potentially leave us disabled for life or worse kill us. It's funny when you think about how fortunate many of us are to have our two legs and two arms...some individuals are not so fortunate to have these and when I hear friends or others complain on- how tough things are and how bad of a day they had, I just remind them to "Have A Heart", because there are a lot of individuals out there who could only wish they were in there shoes or as healthy as you are!