Mitral valve prolapse

Background
  • 1 or more mitral valve leaflets bow into left atrium during systole
  • Most common valve disease in industrial countries (2.4% of pop.)
  • Myxomatous degeneration from connective tissue disorder

Clinical Features

Symptoms
  • Studies failed to demonstrate that chest pain, anxiety, or palpitations are associated with MVP
  • Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance
  • If progresses to MR, CHF symptoms

Physical exam
  • Mid-systolic click
  • Late systolic murmur, crescendo into S2
    • Increasing preload decreases murmur while decreasing preload increases murmur
  • May have associated physical features:
    • Pectus excavatum
    • Scoliosis
    • Low body weight
    • Marfanoid habitus

Differential Diagnosis

Valvular Emergencies

Evaluation

Workup
  • ECG can show nonspecific changes or arrhythmias
  • CXR usually normal
  • Echocardiography

Diagnosis
Transesophageal echocardiogram of mitral valve prolapse
  • Echocardiogram is gold standard

Management
  • Asymptomatic
    • None
  • Symptoms of autonomic dysfunction
  • Signs of progression to MR
    • Early surgical repair
  • Neuro sequelae
  • Click / Murmur

Complications

References
    This article is issued from Wikem. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.