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Mitral valve prolapse - Treatment

Alternative Names

Barlow syndrome; Floppy mitral valve; Myxomatous mitral valve; Billowing mitral valve; Systolic click-murmur syndrome; Prolapsing mitral leaflet syndrome

Treatment:

Most of the time, there are no (or few) symptoms, and treatment is not needed.

If you have severe mitral valve prolapse, you may need to stay in the hospital. You may need surgery to repair or replace the valve if you have severe mitral regurgitation or your symptoms get worse. Mitral valve replacement may be needed if:

  • You have symptoms
  • The left ventricle of the heart is enlarged
  • Heart function gets worse (depressed ejection fraction)

In the past, some people with mitral valve prolapse were given antibiotics before certain dental or surgical procedures to help prevent an infection called bacterial endocarditis (BE). However, the American Heart Association no longer recommends routine antibiotics before dental procedures or other surgical procedures for patients with only mitral valve prolapse, unless they have had bacterial endocarditis in the past.

Other drugs that may be prescribed when mitral regurgitation or other heart problems are also present:

  • Anti-arrhythmic drugs help control irregular heartbeats.
  • Water pills (diuretics) help remove excess fluid in the lungs.
  • Propranolol is given for palpitations or chest pain.
  • Blood thinners (anticoagulants) help prevent blood clots in people who also have atrial fibrillation.

Expectations (prognosis):

Mitral valve prolapse should not negatively affect your lifestyle. If the leaky valve becomes severe, your outlook may be similar to that of people who have mitral regurgitation from any other cause.

Most of the time, the condition is harmless and does not cause symptoms. Symptoms that do occur can be treated and controlled with medicine or surgery. However, some irregular heartbeats (arrhythmias) associated with mitral valve prolapse can be life-threatening.

Complications:

  • Endocarditis -- valve infection
  • Severe leaky mitral valve (regurgitation)
  • Stroke
  • Clots to other areas
  • Irregular heartbeat (arrhythmias), including atrial fibrillation

Calling your health care provider:

Call your health care provider if you have:

  • Chest discomfort, palpitations, or fainting spells that get worse
  • Long-term illnesses with fevers
  • Reviewed last on: 5/4/2010
  • Issam Mikati, MD, Associate Professor of Medicine. Feinberg School of Medicine, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

American College of Cardiology/American Heart Association. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease). J Am Coll Cardiol. 2006;48:1-148.

Nishimura RA, Carabello BA, Faxon DP, Freed MD, Lytle BW, O'Gara PT, et al. ACC/AHA 2008 guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52:676-685.

Karchmer AW. Infective endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 63.

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