Mitral Valve Prolapse - Causes, Symptoms, Diagnosis, and Treatment

Introduction:

The heart has valves that maintain blood flow in the correct direction. There are four valves in a human heart. The heart has four chambers- two upper sections, the right atrium, and left atrium, and two lower sections, the right ventricle and left ventricles. Parallel to four chambers, the heart has four valves: mitral, tricuspid, aortic, and pulmonary. Valves are a crucial part of the heart’s structure. They open and close as the blood passes through them. They mainly regulate the entry and exit of blood into the heart’s various chambers.

The valves have flaps or leaflets that open and close. Valves with three leaflets open and close simultaneously. In order to avoid any sort of backflow of blood, the leaflets close, and vice versa is why they open. The mitral or bicuspid valve allows blood to flow smoothly from the left atrium into the left ventricle. It has two leaflets. The tricuspid valve allows blood to flow easily from the right atrium into the right ventricle. It has three leaflets. The aortic valve controls smooth blood flow from the left ventricle to the aorta. The pulmonary valve has the primary function of allowing smooth blood flow from the right ventricle into the pulmonary artery. It has three leaflets.

How Do Heart Valves Work?

The four valves have the primary function of opening and closing according to the heart’s blood flow. Therefore, when working without interruptions, the four heart valves assure no backflow of blood.

• Open tricuspid and mitral valves allow the blood to flow from the atrium on the right side into the ventricle of the same side and from the left atrium into the left ventricle.

• A closed tricuspid is when the right ventricle is full. It closes to keep the blood from flowing backward into the right atrium when the ventricle contracts.

• The mitral valve closes when the ventricle is up to its total capacity. This keeps blood flowing backward into the left atrium when the ventricle contracts.

• The pulmonary then open as the right ventricle begins to contract. Blood is then flown out of the right ventricle through this heart valve inside the pulmonary artery and eventually into the lungs.

• Next, the left ventricle begins to contract, and the aortic valve opens up. Blood is pumped out of the left ventricle through this valve into the aorta.

• The aorta branches into several arteries and thus provides blood to the body. Aorta is known to be the largest blood vessel of the heart as well as the entire body. It is highly flexible and has three leaflets.

• Closed pulmonic is when the right ventricle finishes contracting and starts to relax, preventing blood from back flowing inside the right ventricle.

• When the left ventricle finishes contracting and begins to relax, the aortic valve is shut, thus avoiding any leakage or backflow of blood into the ventricle.

• This pattern repeatedly occurs, causing blood to flow continuously to the vital organs, primarily the heart, lungs, and rest of the body.

What Causes Mitral Valve Prolapse?

Mitral valve prolapse develops due to various underlying factors that may not have been diagnosed and treated on time. There are many reasons for mitral valve prolapse in individuals ranging from congenital disabilities to age-related changes.

Mentioned below are some of the causes of mitral valve prolapse.

• Rheumatic heart disease.

• Endocarditis is an infection of the lining present within the heart.

• Intravenous drug.

• Untreated, long-standing infection of the heart.

• Degenerative changes.

• Infection of the blood.

• Congenital heart valve disease.

• Myocardial infarction.

• Heart failure.

• Atherosclerosis.

• Thoracic aortic aneurysm.

• High blood pressure.

• Lupus.

• Marfan syndrome.

• Exposure to high doses.

• Autoimmune conditions.

• Age.

• Valve ring dilatation.

• Syphilis aortitis.

• Traumatic valve rupture.

• Trauma to the papillary muscle.

• Senile degenrative alterations.

• Connective tissue disorders.

• Atrial fibrillation.

• Mitral valve prolapse.

• Mitral annular calcification.

• Malignant carcinoid.

• Iatrogenic pacer-led implantation.

• Right ventricular biopsy.

• Chronic right ventricular pacing.

What Are the Signs and Symptoms of Mitral Valve Prolapse?

The development of mitral valve prolapse may happen in a short span of time or may even take years. Depending on the time of onset, clinical manifestations vary accordingly. Once the condition is quite advanced, there are some signs and symptoms that a patient may present with.

Mentioned below are a few of the signs and symptoms of mitral valve prolapse.

• Shortness of breath.

• Chest pain.

• Fatigue.

• Dizziness.

• Fainting.

• Fever.

• Rapid weight gain.

• Irregular heartbeat.

• Fluttering sensation in the chest.

• Lightheadedness.

• Coughing.

• Swollen ankles.

• Bloating of the abdomen.

• Tightness in the chest.

• Difficulty sitting up.

• Insomnia.

• Inability to engage in physical activities.

• Tiredness after a short distance walk.

• Heavy breathing after and while climbing stairs.

• Heart murmurs.

• Enlargement of the liver.

• Palpitations.

• Swelling of the feet.

• High or low blood pressure depends on the affected valve.

What Are the Other Names of Mitral Valve Prolapse?

Mitral valve prolapse is a condition of the heart's mitral valve wherein the mitral valve either bulges out or does not close smoothly. There are several names by which mitral valve prolapse is referred.

Mentioned below are the other names of mitral valve prolapse.

• Click-murmur syndrome.

• Mitral prolapse.

• Myxomatous mitral valve disease.

• Barlow syndrome.

• Billowing mitral valve syndrome.

• Floppy valve syndrome.

How Is Mitral Valve Prolapse Diagnosed?

Mitral valve prolapse may be diagnosed during a regular consultation with a physician after a few extra diagnostic tests. A stethoscope can pick up any abnormal heart murmurs and regurgitation sounds. To confirm the presence of valvular regurgitation or valvular stenosis, additional tests such as those mentioned below may be suggested. Physical examination and a detailed account of medical as well as drug history are vital for the diagnosis of mitral valve prolapse.

• Electrocardiography.

• Ultrasound of the heart.

• Complete blood picture.

• Doppler echocardiography.

• X-ray of the chest.

• Transesophageal echocardiogram.

• Magnetic resonance imaging of the heart.

• Catheterization.

How Is Mitral Valve Prolapse Treated?

The treatment of mitral valve prolapse or any other cardiovascular disease generally depends on the severity of the condition. Therefore, there are choices of both noninvasive as well as invasive approaches today. Considering the clinical manifestations and the results of the diagnostic tools, the healthcare provider will discuss the preferred treatment modality with the patient and family. Below are several of the treatment modalities for mitral valve prolapse.

• Vasodilator therapy.

• Diuretics or water pills.

• Beta-blockers.

• Endocarditis prophylaxis.

• Anticoagulation.

• Open heart surgery.

• Mechanical valve insertion.

• Bioprosthetic valve repair.

• Mitral clip.

• Balloon valvuloplasty.

• Transcatheter aortic valve replacement or TAVR.

• Transcatheter mitral Valve Replacement or TMVR.

• Cardiac rehabilitation.

Conclusion:

Mitral valve prolapse is a condition in which the heart's mitral valve does not close properly or may even bulge outwards. Mitral valve prolapse leads to regurgitation or leaking of the heart. A heart murmur is one of mitral valve prolapse's most common clinical manifestations. In the majority of cases, mitral valve prolapse is not dangerous. However, this does not mean mitral valve prolapse requires no treatment. Mitral valve prolapse can be detected during routine examination of the cardiovascular system. It has been studied that patients suffering from mitral valve prolapse tend to develop anxiety. A healthy diet that keeps the heart strong and regular exercise are key factors in preventing cardiovascular diseases. A routine medical examination is also a must due to the lifestyle we live today.