Treatment and complications of mitral valve prolapse

Mitral valve prolapse is the most common heart disease present in young women. There may or may not be any cause, but its familial tendency is proven. Details about mitral valve prolapse may be seen at Mitral valve prolapse : A heart disease of young women

Though most of the cases of mitral valve may be asymptomatic and may occur sometimes as a normal variant in case of anxiety, but in severe cases there may be palpitation, arythmia, fatigue, chest pain and even fever.

Diagnosis is done by ECG, but confirmatiory diagnosis is by echocardiography. Details of symptoms and diagnosis can be seen at Symptoms and diagnosis of mitral valve prolapse.

Treatment of mitral valve may be simple reassurance to prescription of some medicines or medical treatment. In much severe case surgical treatment may be required.

Medical treatment of mitral valve prolapse

The treatment of mitral valve prolapse may consist of reassurance in asymptomatic cases to medical and surgical implications as per the severity and complications.
The medical treatment may consist of the following-

Beta blockers

In case when the mitral valve prolapse is associated with symptoms like fatigue, irregular heart beats, palpitaions or chest pain, beta blockers are used. The main beta blocker used is atenolol or metoprolol. How ever many doctors even prescribe calcium channel blockers like verapamil for this symptoms.

Antibiotics

Many doctors do not find the use of antibiotics in this disease, but a prophylactic antibiotic is necessary to prevent from a deadly complication called infective endocarditis.

Aspirin and anticoagulants

The associated regurgitation or even the prolapse may lead to formation of embolus and can cause ischaemic heart disease, to prevent this low dose aspirin is given. The dose of aspirin is a debatable issue and doctors prefer from 75mg per day to even 300 mg per day. Regular use of aspirin certainly can cause gastritis, so now a days clopidogrel and ticlopidine is also used for tha same purpose, but still aspirin is most preferred. Other anticoagulants may be used with aspirin.

Surgical treatment of mitral valve prolapse

Surgical treatment of mitral valve prolapse is necessary when it is associated with severe mitral regurgitation. The main surgical procedures done are

Valvuloplasty

In valvuloplasty the repair of valve is done, it may be balloon valvulaplasty where a balloon is placed which acts as a valve. The valve leaflets are reconnected and excess tissue of the valve is plicated.

Valve replacement

Valve replacement is done where there is no scope of valve repair. In this case a metallic valve is replaced in place of original valve. Now a days biological valves are even used such as valve of pigs and this may have a better compatibility and oral anticoagulants may not be required which is essential in mechanical or metallic valves. However a boilogical valve may need frequent replacement, thus havent been much encouraged.

Complication of mitral valve prolapse

In severe cases mitral valve prolapse may have some serious and severe complications, these complications may need serious attention and immediate hospitalization. These complications are-

Congestive heart failure

Congestive heart failure may be due to severe mitral regurgitation, which itself is a complication of mitral valve prolapse. The heart is congested due to leakage of blood and there may be increase in afterload and may lead to failure.

Infective endocarditis

Infective endocarditis is a serious complication as the congestion of blood may make the endocardium more prone to get infected. A prophylactic antibiotic may prevent this deadly complication.

Arrythmia

Irregularity in heart beat is due to abnormal flow of blood in left chamber of heart, this arrythmia may be harmless, but may also cause sudden cardiac death, an antiarrythmic drugs is sometimes necessary to combat this situation.

Thus mitral valve prolapse is the commonest heart disease of young females and every time a youngious or have palpitation, a complete check up is absoliutely necessary.