Medicines for Mitral valve prolapse

What it is

Mitral valve prolapse is a common condition in which the mitral valve — the valve between the two left chambers of the heart — bulges (prolapses) slightly backwards as the heart contracts, because its leaflets are a little floppy. It is one of the most common heart valve variations and, in the great majority of people, is harmless and causes no problems. Many people have no symptoms at all and are found to have it incidentally (for example when a doctor hears a particular heart sound, a "click" or murmur, on examination, or on an echocardiogram scan). Some people report symptoms such as palpitations, atypical chest sensations, tiredness or light-headedness, though these are often not directly caused by the prolapse itself. In a minority of people, the floppy valve allows some blood to leak backwards through it (mitral regurgitation); when this leak is significant, it can, over time, put strain on the heart and cause symptoms, which is the main situation where treatment becomes relevant. For most people, though, mitral valve prolapse is a benign finding needing only reassurance and occasional monitoring.

How it is treated

For the majority with mitral valve prolapse and no significant valve leak, the main part of care is reassurance and, where appropriate, periodic monitoring — as it is a benign condition that usually needs no treatment. The diagnosis and the degree of any valve leak are assessed with an echocardiogram (an ultrasound scan of the heart), which guides how much, if any, follow-up is needed. Where there are troublesome symptoms such as palpitations, these are assessed and managed (for example checking the heart rhythm and reducing triggers like caffeine), often reassuringly. In the minority who develop significant mitral regurgitation (a notable leak), regular monitoring with echocardiograms tracks the heart and valve over time, and if the leak becomes severe or begins to affect the heart, a specialist may consider treatment, which can include repairing or replacing the valve. Any associated rhythm problems are managed as needed. Routine antibiotic prevention before dental work is not generally recommended for most people. The reassuring message is that mitral valve prolapse is very common and usually harmless, needing only reassurance and sometimes monitoring, with treatment reserved for the minority who develop a significant valve leak.