Family doctor

What is it?

Mitral valve prolapse is a condition whereby the mitral valve tissue is too floppy. It is sometimes called 'floppy mitral valve'.

The function of the mitral valve is to prevent backleak when the left ventricle contracts to eject blood around the body. Mitral valve prolapse is a common condition, affecting about 5% of people. There is a wide variation in severity of the condition and I have listed some possible scenario's below.

Levels of severity:

1. Many people with mild prolapse will not have significant backleak (regurgitation) and will never know about their condition. It will not affect their life in any way.
2. Sometimes your doctor will listen to your heart and hear a noise ('murmur') caused by backleak of blood through a floppy mitral valve. This may lead to further investigation such as an echocardiogram to prove that mitral valve prolapse is present. The echocardiogram will also detect how much regurgitation is present. If the degree of mitral regurgitation is mild or greater, you will need to take antibiotics when you visit the dentist or have any medical procedures. You must tell any doctor about this before you undergo any procedure. The antibiotics are necessary because the leaking valve is an attractive site for bacteria to settle on and cause a serious infection of your heart.
3. If your floppy valve leak is significant you should be followed by a cardiologist and have regular echocardiograms. This is because the leak may get worse over time. If the leak is bad enough it will cause damage to the left ventricle (the main pumping chamber of your heart). This can be monitored with regular echocardiograms. When the ventricle reaches a certain size (usually an 'end systolic dimension' = 4.5cm) you may be recommended to undergo surgery.
4. Previously, the only way to fix a badly leaking valve was to implant an artificial valve, either mechanical (plastic and metal) or tissue (from another person or from an animal). Today, many floppy valves can be repaired.