Exercise and Mitral Valve Prolapse
By: Kristine A. Scordo, M.D.
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Mitral Valve Conditions
Overview of Mitral Valve Prolapse
Mitral valve prolapse, is a common condition in which the mitral valve leaflets are floppy or loose. Mitral valve prolapse is diagnosed by echocardiography. Most patients with mitral valve prolapse do not have a leaky mitral valve and do not require surgery. When a valve with prolapse has a severe leak, surgery should be considered.
In a normal valve, the flow of blood goes from the left atrium to the left ventricle. Upon closing, it prevents blood from going back into the left atrium. With MVP the flaps fail to close evenly. One or both flaps collapse backwards, sometimes allowing a small amount of blood to leak through the valve.
Mitral valve prolapse, sometimes known as mitral insufficiency or mitral valve regurgitation, is a genetic disorder and seems to affect women three times more than men. It is one of the most common cardiac findings.
Infection of the mitral valve, endocarditis, is extremely rare. However, people with MVP have a slightly greater risk of contracting it.1
About the Mitral Valve
The heart has four valves, which open and close to keep blood flowing in the proper direction through the heart. The mitral valve connects the heart's upper-left chamber (atrium) to the heart's lower-left chamber (ventricle).
Mitral valve stenosis-or mitral stenosis-is a narrowing of the mitral valve. This narrowing causes the valve to not open properly and to obstruct blood flow between the left chambers of the heart.
Mitral valve regurgitation, or mitral regurgitation, occurs when the mitral valve doesn't close tightly, allowing blood to flow backward in the heart.
Other Names for mitral valve prolapse
Barlow's syndrome
Floppy mitral valve
Myxomatous mitral valve
Billowing mitral valve
Systolic click-murmur syndrome
Prolapsing mitral leaflet syndrome.2
Echocardiography Definition
Echocardiography is a noninvasive diagnostic procedure that uses ultrasound to study to structure and motions of the heart.
Symptoms of Leaky Heart Valve
Many patients with mitral valve disease are asymptomatic (have no symptoms), even with a leak that is severe. When symptoms develop, they include shortness of breath, fatigue, loss of energy, swelling of the ankles and palpitations (extra or skipped heart beats).
Usually symptoms do not show up before the age of 14 or 15, but more and more children display central nervous system symptoms before the MVP shows up. Ninety-eight percent of people with mitral valve prolapse Syndrome have nothing wrong with their heart. The majority of symptoms are caused by an out-of-balance nervous system.3
Diagnosis
The first step in diagnosing mitral valve prolapse involves listening with a stethoscope. Using a stethoscope, the doctor hears a murmur, which represents turbulent blood flow across an abnormal valve. The diagnosis is confirmed by an echocardiogram. Ultrasound is used in an echocardiogram to allow the doctor to visualize the heart valves and determine the severity and cause of the leak. In most patients, a standard transthoracic echocardiogram (a probe placed on the skin of the chest) is adequate to visualize the valve. Sometimes a transesophageal echocardiogram (a probe passed through the mouth into the esophagus) is necessary to more closely visualize the valve; this is an outpatient procedure.