Mitral valve prolapse : A heart disease of young women

Mitral valve prolapse is known by many names like mitral valve prolapse, floppy mitral valve or Barlow's syndrome. It is most commonly seen in young females and have a familial incidence.

Though mitral valve prolapse remains asymptomatic and may not need surgical replacement of the valve as the prolapse is in posterior cusp of mitral valve and it may be differentiated from Read's syndrome where both antrerior and posterior cusps prolapses and invariably needs a valve replacement.

What is mitral valve prolapse

Human heart contains four valves namely mitral, tricuspid, aortic and pulmonary valves. Mitral valve is the valve present between left atrium and left ventricle of the heart and opens during diastole when pure blood flows from atrium to left ventricles from where it is supplied to whole body.

The mitral valve leaflets may be large in mitral valve prolapse. Alternatively there may be enlarged mitral annulus, abnormally long chordae which is the strings attached to the underside of the leaflets and connected to the ventricular wall, or disordered pappilary muscle contraction. These all may lead to prolapse of the mitral valve leaflet into the left atrium during ventricular systole and may cause abnormal contraction and mitral regurgitation which means a very small amount of blood may leak through, moving backward from the ventricle to the atrium.

Causes of mitral valve prolapse

In majority of cases the exact cause of mitral valve prolapse is unknown. Though mild mitral valve prolapse is very common and is often considered as a normal variant and can be seen in patients with anxiety neurosis and in hyperactive stage. There may be some pathological conditions too where mitral valve prolapse can occur, these are

Rheumatic heart disease

It is the heart disease associated with the abnormality of the heart muscles, the defect in chordae can occur in rheumatic heart disease and can lead to mitral valve prolapse.

Ischaemic heart disease

Though this is a rare cause of mitral valve prolapse, but a very common disease now a days and occurs due to less oxygen supply to the heart leading to ischaemia. Often the leaflets becomes weak and prolapse due to change in normal pressure of the atrium and ventricles.

Marfans syndrome

Marfans syndrome is a connective tissue disorder and apart from heart it can affect eyes, skeleton, blood vessels, nervous system, skin, and lungs. There may be other valvular disease like mitral valve regurgitation along with mitral valve prolapse.

Thyrotoxicosis

Thyrotoxicosis is an inflammation of thyroid gland along with hyperthyroidism. It often leads to anxiety neurosis and many may develop mitral valve prolapse.

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is a symmetrical thickening of heart muscle. This asymmetrical thickening may lead to prolapse of the cusp causing mitral valve prolapse.

Atrial septal defect

Atrial septal defect is a congenital non cyanotic defect of the heart where there is defect in the atrial septum and blood may flow from ventricle to atrium. Though this is not a cause of mitral valve prolapse but it is often present along with atrial septal defect.

Features of mitral valve prolapse

Mitrla valve prolapse as mentioned may be a normal variant and may be asymptomatic in many cases, but fever, chest pain are some common complaints. Diagnosis is often done by electrocardiogram and confirmed br echocardiography. Details of symptoms and diagnosis is geven at Symptoms and diagnosis of mitral valve prolapse.

Treatment consists of beta blockers, some may even require surgical interventions, details of treatment may be seen at Treatment and complications of mitral valve prolapse.