What Mitral Valve Prolapse Is Part 2/2

What Mitral Valve Prolapse Is Part 2/2

May presents a case of mitral valve prolapse. She had really significant symptoms of palpitations which is a fluttering sensation of the chest, being short of breath and also having chest discomfort, and these symptoms limited her lifestyle. She was unable to do the things she want to do in particular sailing and other activities and only with medications in her particular case did she feel better, was able to go back to the activities she enjoy.

Mitral valve prolapse in its simplest form is a condition with the mitral which is an inflow valve bringing blood back from the lungs and through the heart, with this valve it prolapses in an abnormal fashion. The valve has to leaflets that open and close, and in normal situation this valve would close in this fashion. But with mitral valve prolapse it buckles backwards and that’s how we make the diagnosis either through ultrasound of the heart or through an examination, and some of those patients the mitral valve itself maybe structurally abnormal. The valve maybe thickened, the valve may have the attachments so the valve will be abnormal and be redundant so the valve moves in a very abnormal fashion.

Some patients though, the valve itself looks very normal, the leaflets are nice and thin and appear normal but seemed to prolapse.

So we can divide up mitral valve prolapse into a couple of different categories. Those with an abnormal thickened valve called mixomities mitral valve prolapse which tends to be the most common type, and in those patients who have a normal mitral valve but still tends to prolapse. It’s also those patients who have the thickedn valve appear to be those of higher risk for more serious complications of mitral valve prolapse, and that can be more serious arrhythmias, or even sudden cardiac death. If you have a thickened valve, that valve tends to leak more often so we have regurgitations. So when the valve opens and closes and buckles backwards it will leak causing regurgitation, abnormal blood flow within the heart and this tends to be a risk for patients to develop more serious complications of mitral valve prolapse.

Treatment strategies for mitral valve prolapse are broken into the high risk patient and the lower risk patient. The high risk patient in which the mitral valve is thickened must be followed more closely. Although these patients are not treated with medical therapy they do need to be watched when they might need surgical therapy to repair or to replace the mitral valve. The majority of patients of mitral valve prolapse will require endocarditis prophylaxis, which means that they require antibiotics prior to a dental procedure or an operation or any condition where they may have bacteria in their blood stream.


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