Frequently Asked Questions
How dangerous is my MVP?
The mitral valve regulates the opening between the left atrium and the left
ventricle. (Click here for a quick
and easy description of the heart's chambers and valves.) As the left
ventricle contracts the mitral valve closes, thereby preventing a backwash of
blood ("regurgitation") into the left atrium. MVP (mitral valve
prolapse) occurs when abnormalities in the mitral valve allow it to flop (i.e.,
to prolapse) back into the left atrium as the left ventricle contracts, thus
allowing a certain amount of regurgitation. In general, the abnormality that
allows prolapse to occur is a congenital excess of tissue on the valve, making
it "floppy."
MVP is extremely common. Roughly 2% to 4% of the general population will have MVP on echocardiographic screening. Further, there is often a genetic predisposition to MVP. If a person has true MVP, it is likely that about 30% of his/her close relatives will also have it.
Fortunately, MVP tends NOT to cause significant mitral regurgitation. Only about 5% of patients with true MVP will develop significant mitral regurgitation over their lifetimes, to the point that mitral valve surgery may be required.
The risk of developing a cardiac infection – endocarditis – increases any time a leaky valve is present within the heart. To prevent endocarditis, it is recommended that patients with MVP take prophylactic antibiotics prior to dental or genitourinary procedures. However, actual cases of endocarditis with MVP are rare.
Overall, the vast majority of patients with MVP can expect to live completely normal lives, and to have completely normal life expectancies.
It has become apparent that MVP is grossly overdiagnosed. Echocardiograms have become so sensitive that it is possible to see (or at least imagine) a “whiff” of mitral regurgitation in almost anybody if you look hard enough. And for doctors desperate to diagnose something in patients with difficult or unusual symptoms, MVP has become a convenient diagnosis to make – even when it’s not really there.
There are two consequences to the overdiagnosis of MVP. First, many people are walking around with the diagnosis of a cardiac problem when they, in fact, have none. This misdiagnosis can cause psychological problems, and can make it unnecessarily difficult to obtain health insurance.
Second, many symptoms have been attributed to MVP that are probably not actually caused by MVP. These include anxiety, chest pain, palpitations, arrhythmias, sudden death, stroke, chronic fatigue syndrome, and fainting. The problem here is that, instead of tracking down the true cause of these symptoms, MVP is diagnosed (often incorrectly) and the true cause of the symptoms goes undiscovered (and untreated.)
Click here for a full discussion of MVP – its diagnosis and overdiagnosis, its consequences, and its treatments.
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