The mitral valve lies between the heart's left atrium and the left ventricle. It has two flaps (leaflets) that open and close like a pair of swinging doors. When the heart beats, the left ventricle pumps blood out to the body and the leaflets swing shut. This keeps the blood in the ventricle from going back into the left atrium. If the mitral leaflets are too floppy, big, thin, or have the wrong shape, they may not shut properly. This condition, called mitral valve prolapse (MVP), allows blood to leak back (regurgitate) into the left atrium.
MVP is a common heart valve defect. It was first described in the 1960s as a heart murmur during the late systolic (contracting) phase of the heartbeat, accompanied by prolapse (improper positioning) of one or both mitral valve leaflets. In the mid-1980s, a study using two-dimensional echocardiography suggested that MVP occurs in nearly 40% of teenage girls. However, due to increased understanding of normal heart valve structure, the definition of MVP was revised to distinguish what is true MVP vs. normal valve structure. According to the Framingham Heart Study, MVP affects between two and three percent of the U.S. population. It remains unclear how many cases are hereditary vs. idiopathic (arising suddenly from an unknown cause). Nonetheless, it is the most common cause of non-ischemic (does not stop blood flow) mitral regurgitation.
Usually, MVP is a genetic (inherited) condition that does not cause health problems. Most patients with MVP require no invasive treatment. However, rare but serious complications may occur, which include severe mitral regurgitation, infectious endocarditis (inflammation of the heart's inner lining), heart attack, stroke, or sudden cardiac death. Echocardiography, which is used to diagnose MVP, may also identify patients at high risk for complications. When necessary, treatment generally involves surgery to physically correct mitral valve defects.
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