Mitral valve prolapse
Cardiology (12%) Core Clinical Conditions
2B: The Physician Associate is able to undertake the day to day management of the patient and condition once the diagnosis and strategic management decisions have been made by another.
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Mitral valve prolapse (MVP) is a heart condition in which the two flaps of the mitral valve, which regulates blood flow between the left atrium and left ventricle, bulge back into the left atrium instead of closing tightly during the heart's squeezing phase. This allows blood to flow backward from the left ventricle into the left atrium.
Aetiology
Combination of genetic and environmental factors.
Pathophysiology
The structural abnormalities of the mitral valve and its supporting structures define mitral valve prolapse: the mitral valve becomes thickened and elongated, causing it to bulge back into the left atrium during systole of the heart rather than being tightly sealed. This causes a small amount of blood to leak back into the left atrium. If left untreated mitral regurgitation may occur.
Risk factors
A family history of MVP.
Connective tissue disorders.
Being pregnant and exposed to toxins or infections.
Sign and symptoms
Chest pain.
Palpitations.
Shortness of breath.
Dizziness.
Heart murmur: mid systolic or late systolic murmur.
Investigations
Physical examination,
24hr electrocardiogram (ECG),
Echocardiogram
Cardiac MRI
Management
Asymptomatic: no treatment needed.
If palpitation, anxiety or chest pain: beta-blockers can be given to help relieve symptoms.
If there is risk of embolism: consider anticoagulation
If a patient develops severe mitral regurgitation: surgical intervention may be considered to repair or replace the mitral valve.
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