What are the risks of having mitral valve prolapse (MVP)?

Infective endocarditis: MVP increases the risk of infective endocarditis, a microbial infection of the heart, by about 800%. However, the annual risk of developing infective endocarditis in MVP patients is low (about 0.02). In MVP patients with a systolic murmur, the risk is higher (about 0.05%). Prophylactic (preventive) antibiotics may be used in high-risk MVP patients, especially those undergoing dental procedures (which increase the risk of developing infective endocarditis), those over age 50, and those with left ventricular dilatation, left atrial enlargement, or leaflet thickening.

Sudden cardiac death: Sudden cardiac death (SCD) is a rare complication of MVP, occurring in about one of every 250 cases of MVP annually (about twice the rate of the normal population). It is unclear what causes SCD in MVP patients, though arrhythmias, particularly ventricular tachyarrhythmias (abnormal heart rhythms that are rapid, with or without other abnormalities) appear to increase the risk of SCD in MVP.

Cerebrovascular ischemic events: Patients with MVP also have a 0.7% risk of cerebrovascular ischemic events, such as heart attack and stroke, which represents a slight increase (about 2-fold) over the rest of the population. The increased risk of cerebrovascular events may be caused by increased coagulation associated with mitral regurgitation.

Severe mitral regurgitation: Mitral regurgitation may progressively worsen in MVP patients, requiring corrective surgery. Severe mitral regurgitation risk increases with body weight, which may explain why MVP-related complications are generally more common in men than in women.

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