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Mitral Valve Prolapse

Also called: Billowing Mitral Cusp Syndrome, J.B. Barlow Syndrome, MVP, Floppy Valve Syndrome, Barlow Syndrome, Systolic Click Murmur Syndrome

- Summary
- About mitral valve prolapse
- Signs and symptoms
- Diagnosis methods
- Treatment options
- Questions for your doctor

Reviewed By:
Abdou Elhendy, MD, PhD, FACC, FAHA
Sumit Verma, M.D., FACC
Stephen D. Shappell, M.D., FACC, FCCP, FACP

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Treatment options for mitral valve prolapse

Patients with no symptoms and no abnormal heart rhythms (arrhythmias) due to mitral valve prolapse (MVP) are usually placed on a “wait and watch” basis, with tests repeated about five years from the initial diagnosis. However, all patients, even those without symptoms, may be advised to do the following:

Take antibiotics shortly before any dental or medical/surgical procedure that involves the risk of bacteria entering the bloodstream. This is due to a higher risk of developing a potentially life-threatening infection of the heart valve called valvular endocarditis. In revised guidelines by the American Heart Association, this pre-medication “antibiotic prophylaxis” pertains to MVP individuals with regurgitation. Those who have MVP without regurgitation generally do not need prophylaxis.
Eat a good diet, including avoiding caffeine, limiting sugar and eating a high-protein snack in the afternoon (e.g., nuts). This may help patients to sustain an adequate energy level and guard against fatigue.
Drink plenty of caffeine-free beverages (e.g., water). This can improve low energy and feelings of dizziness or weakness.
Engage in regular exercise. With guidance from a physician, exercise can help to relieve symptoms and improve overall health and energy levels.

Depending on the patient’s symptoms, medications may also be prescribed. These include:

Beta blockers. These drugs minimize the effects of stress hormones on cardiovascular functions, slowing the heart rhythm and minimizing the stress on the floppy mitral valve. Beta blockers also often help to relieve the associated chest pain.
Vasodilators. These medications help expand the blood vessels and reduce the workload on the heart. They may be used for patients who have significant regurgitation and to prevent serious symptoms.
Antiarrhythmics. To regulate heart rhythms. Although beta blockers remain the initial therapy for arrhythmias, side effects sometimes lead to the use of alternative antiarrhythmic medications.

If the MVP progresses to significant leakage (regurgitation) and heart failure, then treatment will shift to address those conditions accordingly.

It is only in the more major cases of MVP with significant regurgitation that a patient will require surgery. Only 2 to 5 percent of MVP patients under the age of 70 develop sufficient regurgitation to require surgery. A surgical treatment would entail heart valve repair or replacement. The chordae may also be treated by the surgeon, as needed. The primary goal of surgery is improve the patient's symptoms and reduce the risk of heart failure.

Researchers are examining the repair of mitral valve regurgitation with a less-invasive procedure. During this procedure, the physician threads a catheter to the mitral valve and fastens a tiny clip to the abnormal valve, thus reducing blood leakage. This treatment is being performed in only a few medical centers and has not yet been shown in large studies to be more effective than traditional surgery.

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Review Date: 02-01-2007