Symptoms and diagnosis of mitral valve prolapse

Mitral valve prolapse also called Barlow's syndrome of floppy valve syndrome or click murmur syndrome is more commonly a disease of young females and may be present even after hyperactive state like anxiety neurosis. There are other causes too. The detail of the cause of mitral valve prolapse may be seen at Mitral valve prolapse A heart disease of young women..

The diagnosis of mitral valve prolapse is based on the clinical symptoms and investigations like ECG and echocardiography. Though many patients remain undiagnosed as they don,t visit the doctor, because most cases may be a normal variant and may not show any symptoms.

Symptoms of mitral valve prolapse

Most of the cases of mitral valve prolapse are asymptomatic and the prolapse is mild. These patients are never diagnosed or accidently diagnosed when investigated for other cause, however no treatment is required in asymptomatic cases.

Fatigue
Among the symptoms of mitral valve prolapse, the most prominent is fatigueness. Due to leakage in the blood flow, patient easily gets fatigued.

Palpitation and anxiety
In mitral valve prolapse there may be increased heart rate and patient may feel the palpitation, this is due to imbalances in the autonomic nervous system controlling heart rate.

Chest pain mimicking angina
Some patient may suffer from chest pain which may be like pain in angina pectoris, but the chest pain in mitral valve prolapse does not changes by exertion and may not be relieved by nitroglycerine.

Fever
In some case there may be associated fever and this may typically indicate mitral valve prolapse in a patient with above symptioms with fever.

Mitral valve prolapse may be rarely associated with strokes occurring in young patients. These patients appear to have increased blood clotting tendencies due to platelets.

Signs of mitral valve prolapse

The signs of mitral valve prolapse is found after auscultating the heart or left precordium. A mid systolic click sound may be heard due to prolapse of the valve and tensing of the chordae tendinae that occurs during systole of contraction of ventricles.

Often the patient with symptomatic mitral valve prolapse may have mitral regurgitation that is leakage of blood from left ventricle to left atrium during systole. Thus a late systolic murmur may be heard due to this leakage, it large regurgitation the murmur may be pansystolic means it may be heard throughout the systole.

Diagnosis of mitral valve prolapse

A mitral valve prolapse can be diagnosed on the basis of certain investigations. An electrocardiography is done and if the abnormaility is seen and there is suspect, echocardiography confirms the diagnosis.

Electrocardiogram

Electrocardiogram in short ECG reveals inverted or biphasic T waves in leads II, III and aVF, there may be ventricular premature contractions as well. Though a normal ECG does not rule out mitral valve prolapse hence echocardigraphy is done which is confirmatory.

Echocardiography

A two dimensional echocardiography is confirmatory diagnosis and it identifies the abnormal position and prolapse of the mitral leaflet. It also identifies the thickening of the leaflet and this condition is more prone for infective endocarditis.

Color doppler studies

Color doppler studies may be helpful in identifying and evaluating the the mitral regurgitation if present.

Angiocardiography

Angiocardiography is done to reveal prolapse of the posterior and sometimes both mitral leaflets.

Treatment of mitral valve prolapse may include from reassurance in asymptomatic cases to even surgical treatment like valvular replacement if a severe mitral regurgitation is associated. Details is give at Treatment and complications of mitral valve prolapse.