Mitral valve prolapse - degrees, causes, symptoms, treatment of MVP. Mitral valve prolapse: symptoms, treatment and prognosis

Conducted since 1948, for almost three decades, the famous American study Framingham Heart Study found that mitral valve prolapse (MVP) is found in 2.5% of people.

In almost half of the cases, the pathology proceeds unnoticed. However, sometimes the disease requires special attention and appropriate therapy.

What is it?

The valve is a double leaflet of connective tissue located between the chambers of the heart on the left side. Its main task is to prevent blood from flowing back into the atrium during cardiac contraction.

In order to understand what mitral valve prolapse is, it is necessary to consider the normal process and compare it with the pathological one.

During systole, the valves open and blood enters the ventricle. Next, the valves close, the ventricle contracts and throws blood into the aorta. As pathology develops, a disruption of the connective tissue structure is detected, which leads to “sagging” of the valve.

Severity of valve deformation

There are three degrees of the disease, depending on the amount of sagging of the valves in millimeters.

Mostly does not affect the patient’s well-being and rarely has symptomatic manifestations. Mild prolapse (1) is a sagging of connective tissue not exceeding 3-5 mm. The condition has a favorable prognosis and, as a rule, does not progress.

More pronounced protrusion of connective tissue towards the left ventricle. Its size ranges from 6 to 9 mm. Grade 2 MVP usually affects the person’s condition and requires monitoring.

3rd degree

Intensive sagging of the valves, amounting to 9 mm or more. It should be noted that grade 3 mitral valve prolapse does not always reflect the severity of the disease. The main criterion for assessing the condition is the degree of blood circulation impairment.

Mitral valve prolapse

Classification by localization of prolapse

With MVP, damage to one of the two leaflets or both at once can be detected.

Front flap

This is the most developed part of the valve. The level of connection of the leaf with the fibrous ring is approximately 5-6 mm below the attachment of the rear part.

Prolapse of the anterior leaflet of the mitral valve is the most common type of pathology. Due to the damage to a large area, it manifests itself more often than other forms.

Rear flap

The pathology is expressed in deflection of the posterior leaflet. The rear part of the valve is smaller, but significantly wider than the front. In 90% of cases, MVP of this type is not dangerous to life and health.

Regurgitation

The name of this phenomenon comes from two Latin words meaning “reverse action” and “fill”. It is the return of blood from the ventricle to the atrium during systole, caused by sagging of the valve walls. It is the assessment of the degree of regurgitation that underlies the determination of the severity of MVP.

Hemodynamically insignificant

If the sagging is less than 3 mm, the patient is diagnosed with prolapse without regurgitation. This is the most harmless form of the disease, requiring periodic monitoring. With a deflection of up to 3 mm, the diagnosis can be made: “Hemodynamically insignificant mitral valve prolapse.” This means that disruption of the connective tissue structure does not affect the functioning of the heart muscle and the body as a whole. It is usually considered a hereditary pathology.

With a significant negative effect on blood circulation

Mitral valve prolapse grade 3 and regurgitation grade 2 negatively affects the functioning of the heart muscle.

The blood flow reaches the middle of the atrial chamber, and in severe cases it touches the walls of the left atrium. This leads to stretching of the heart chamber and, as a consequence, to the development of heart failure. The condition does not tolerate inaction, but requires prompt action. The patient requires consultation with a cardiac surgeon.

Is this a heart defect or not?

Conventionally, “heart disease” means a defect in an organ or large vessels. According to this definition, the answer to the question of what mitral valve prolapse is, heart disease or not, should be answered positively. However, in most cases, this phenomenon is so insignificant for the patient’s well-being that it is classified as a cardiac anomaly.

Some cardiologists say that “the valve has the right to be defective,” comparing the heart with a MVP to a nose that has a slight hump. The defect is visually present, but does not affect the quality of life. However, for patients with hemodynamically significant prolapse, the consequences may be completely different.

Severe forms of MVP that have a serious impact on the functioning of the heart are valve disease (mitral regurgitation).

ICD 10 code

In 1997, the International Classification of Diseases, 10th revision, was introduced throughout the country. Mitral valve prolapse also received its place in the classification. ICD-10 includes pathology in class I under the number 34.1 (I34.1).

Symptoms

The clinical picture of the pathology depends on the degree of regurgitation, health status, age and lifestyle of the patient.

Table 1. Symptoms and manifestations of mitral valve prolapse

Chest pain	They can be piercing, cutting, or pulling in nature. Mostly found after exercise or stress
Sinus rhythm disorders	Tachycardia and extrasystole can be provoked by a cup of coffee, an emotional outburst and physical activity. Prolapse can manifest itself as a feeling of “freezing” of the organ, sharp jolts, “interruptions”
Autonomic dysfunction	There may be a feeling of nausea, a foreign body in the throat, rapid loss of performance, and sleep disturbances. Sometimes the patient complains of panic attacks
Change in body temperature	The appearance of a slight low-grade fever
Breathing disorders	A sudden need for oxygen, rapid breathing, shortness of breath
Loss of consciousness	Can be triggered by stuffiness, high temperature, stress, or occur without obvious reasons

A competent specialist will already suspect mitral valve prolapse from the history. Women and children tend to experience symptoms more frequently than men.

In the vast majority of cases, the pathology occurs without symptoms.

Does your heart hurt?

Some patients believe that any heart disease is accompanied by discomfort.

Does prolapse “hurt”? As a rule, the patient does not complain of any sensations in the chest. Isolated tingling sensations are possible, but in a calm state they are practically undetectable. The exception is severe mitral valve prolapse with grade 2-3 regurgitation, in which pain occurs more often.

Features in different groups of patients

Pathology can occur differently, depending on the category of patients. In addition, for some categories of patients MVP is more dangerous.

In children

Pathology is found in children of any age. Mitral valve prolapse is least often diagnosed in children who have just been born. As a rule, the disease is combined with other connective tissue pathologies, which leads to the appearance of characteristic signs of MVP.

Table 2. Secondary signs of prolapse in a child

Appearance Features	Arachnodactyly, tall stature, asthenic physique, elongated torso and shortened limbs, etc.
Head	Long heads, high “Gothic” palate, ears set lower than usual, etc.
Eyes	Myopia, bluish tint of whites
Breast	Concavity, elongation, scoliosis
Skin	Paleness, thin vulnerable skin, tendency to bruises and abrasions
Vessels	Possible varicose veins
Joints	Extremely mobile and flexible

According to available statistics, the diagnosis occurs in parallel with other disorders in 89% of cases. In half of the children, the pathology causes disharmonious development.

In teenagers

The largest number of complaints about the manifestation of MVP occur in adolescents over 12 years of age, with the majority of patients being girls.

The appearance of symptoms is associated with hormonal changes that arise due to the onset of adolescence. Psycho-emotional disorders and depressive states are often registered in young people. Often, prolapse in adolescents requires observation not only by a cardiologist, but also by a neurologist and a psychotherapist.

In women

Another risk group is young girls. Although the diagnosis is often discovered in middle age. In the fair sex, MVP is in some cases associated with asthenic syndrome and autonomic dysfunction.

In pregnant women

Early stage pathology is rarely detected. However, in most cases this is not due to pregnancy, but to the identification of this valve feature during examination. Mitral valve prolapse and pregnancy require monitoring the health of the expectant mother by an obstetrician-gynecologist together with a cardiologist. In case of stage 2-3 MVP complicated by regurgitation, the woman is given personal recommendations. Typically, such patients are observed in specialized institutions.

How is it reflected on the ECG?

Electrocardiography does not always detect pathology; echocardiography and ultrasound of the heart are mainly recommended for diagnosis. Prolapse on an ECG can manifest itself as follows:

scattered negative T-waves without ST segment displacement;
negative T-waves in the leads from the arms, legs and left chest against the background of a slight displacement of the ST segment;
negative T waves and ST segment elevation;
prolonged QT interval.

Reasons

People are born or “earn” prolapse later. The causes of myxomatous changes in connective tissue are still not known for certain. Considering the fact that MVP is usually combined with other pathologies, the disease is likely genetically determined.

Why is this defect dangerous?

MVP has virtually no effect on the quality of life, but the risk of sudden cardiac death in a patient with this diagnosis increases up to 3-5 times.

Table 3. Mitral valve prolapse: what is dangerous, consequences

Rupture of chordae tendineae	With severe MVP, the apparatus holding the valve may be torn off, leading to separation of the leaflet
Mitral valve insufficiency	Acquired heart defect
Fibrin deposits on the valve	Increased risk of thromboembolism
Arrhythmia	Any heart rhythm other than sinus (tachycardia, bradysystole, etc.)
Cerebrovascular pathologies	Ischemic/hemorrhagic stroke, transient ischemic attack, etc.
Sudden cardiac death	Only in severe forms of HF against the background of prolapse

Can it disappear on its own?

Some patients get rid of MVP without effort. Answering the question of whether mitral valve prolapse can disappear, a positive answer should be given.

Similar cases have been reported in children. The valves become stronger with age, and the valve returns to its normal state. However, similar cases have also been recorded in adults.

How to treat?

MVP only in rare cases requires special therapy. In general, no treatment is required.

Drugs

Table 4. Mitral valve prolapse - treatment, drugs recommended by doctors

Folk remedies

Herbal therapy is based on the consumption of drugs that have a sedative effect. Thus, it is strictly forbidden to stop severe prolapse. Treatment with folk remedies must be agreed with a doctor. Mainly used:

motherwort;
peppermint;
chamomile;
peony tincture;
tincture of valerian, etc.

Review of reviews about the disease and its treatment

People with established MVP usually live and work without any restrictions. Most people do not feel the prolapse at all. Reviews report that only some patients experience unpleasant symptoms (fatigue, headache). A few were forced to seek surgical help.

Consequences

We will consider in this paragraph exactly what restrictions patients suffering from MVP face.

Limiting physical activity

For grade 1 and 2 MVP with mild reverse flow, no activity restrictions are required. In severe cases, it is recommended to avoid activities with increased intensity.

Is childbirth possible with this disease?

During pregnancy, it is worth performing ultrasound several times. If the study does not reveal any deterioration in comparison with previous data, and MVP is not higher than grade 2, then it is not dangerous to combine prolapse and childbirth.

Is it possible to play sports?

In order to determine suitability for playing sports, it is necessary to refer to the recommendations of the All-Russian Society of Cardiologists. The absence of the following symptoms and pathologies will help you understand whether you can play sports with prolapse:

loss of consciousness;
arrhythmias (requires Holter and ECG monitoring);
thromboembolism;
deaths among close relatives caused by prolapse.

If one of the factors is detected, then it is permissible to engage in low-intensity sports.

With a slight reverse current, but maintaining normal rhythm, size and size of the heart muscle, any competitive disciplines are allowed. Therefore, prolapse and sports are quite compatible.

Do they take you into the army?

Young people of military age who have valvular anomaly rightfully ask the question of whether they are accepted into the army with mitral valve prolapse. If the pathology does not affect the activity of the cardiovascular system, then there are no contraindications for the service.

Useful video

You can learn more about mitral valve prolapse from this video:

Conclusion

Having seen the diagnosis, a person wonders what it is - prolapse. After 40 years, this pathology can indeed worsen. However, it poses a real danger in isolated cases.

Often severe symptoms are a consequence of the patient’s worries about his state of health. How to treat mitral valve prolapse and prevent possible complications is determined by a cardiologist.

Mitral valve prolapse of the 1st degree with regurgitation of the 1st degree is a pathological process in which the development of the connective tissue of the heart muscle is disrupted.

The mitral valve itself has two soft flaps that are regulated by the papillary muscles. The valves regulate the flow of blood so that it moves in only one direction.

When these valves begin to malfunction, doctors use the term “prolapse.”

Pathogenesis of the disease

The human heart has two upper (atria) and two lower (ventricles) sections. The valve, which is located on the right, has three shutters. The left valve (mitral) is bicuspid.

E If the connective tissue loses its elasticity and becomes more pliable, the valves protrude towards the atria under the pressure of contractions of the upper chambers. As a result of this phenomenon, a certain amount of blood is thrown back. Thus, the ejection function is reduced.

Mitral valve prolapse with regurgitation is the sagging of the valve with blood returning back. With 1 degree of pathology, the valves deviate by 3–6 mm.

With such pathological changes, the heart is no longer able to function normally. Mitral valve dysfunction usually leads to stenosis or heart failure.

Types of pathology

The initial stage of the disease is divided into two types - with regurgitation (blood reflux) and without it. Doctors distinguish the following degrees of pathology:

Zero. The valves only bend, but do not diverge, so there is no return of blood.
First. With prolapse of the anterior leaflet of the mitral valve of the 1st degree, a slight divergence of the valve flaps is observed, which causes the blood to turn back.
Second. The blood that is thrown from the ventricle reaches half of the atrium.
Third. The blood stream is very intense, it reaches the back wall of the upper chamber.

Reasons

Depending on the causes of occurrence, there are two types of MVP of the 1st degree - congenital and acquired.

The latter, in turn, can be caused by factors such as:

Coronary heart disease. This disease occurs due to blockage of the lumens of blood vessels with atherosclerotic deposits. With ischemia, pathological changes affect the papillary muscles and chords, which can lead to rupture of heart tissue during a heart attack.
Rheumatism. This disease develops as an autoimmune reaction to certain types of bacteria. In parallel, other valves are affected, as well as joints.
Injuries that lead to serious organ damage.

It should be noted that congenital prolapse can be without regurgitation, not progress and be absolutely safe for the body.

However, this pathology should be identified in childhood in order to know how to take care of your health in the future.

Symptoms

Mitral valve prolapse of the 1st degree with regurgitation of the 1st degree often does not have a pronounced clinical picture. Sometimes there are no symptoms at all.

And yet, this disease can be confirmed by mild signs:

chronic headaches, dizziness;
dyspnea;
fainting states;
different types of arrhythmia;
low-grade fever;
vegetative-vascular dystonia (rare).

The first stage of pathology with minor regurgitation, which passes without complications, as a rule, does not pose a threat to the pathological development of the fetus.

But even if a woman is not worried about anything, before a planned pregnancy she will need to consult a doctor who should monitor her condition during pregnancy.

MVP in a child

In children, this pathology occurs quite often, and in girls more often than in boys. The congenital defect is characterized by a special structure of the connective tissue of the heart muscle. Just like in adults, in children MVP manifests itself weakly or strongly.

A third of adolescents diagnosed with MVP complain of chest pain and rapid heartbeat. These signs intensify under the influence of stress, physical activity, and oxygen starvation of the body.

Children with grade 1 MVP experience symptoms of a neuropsychological nature. Such patients have changeable moods, have nervous breakdowns and even fainting. They often feel tired even at rest.

Diagnostics

These diagnoses can be easily confirmed using known diagnostic measures:

auscultation (examination of the patient, which involves listening to the heart with a phonendoscope);
ECG - electrocardiography (allows you to identify extrasystoles, arrhythmia and other manifestations of pathology);
Holper ECG (monitors heart function throughout the day);
Ultrasound of the heart muscle (allows you to study the condition of the valves, the degree of their death and regurgitation).

Sometimes a specialist may refer you for additional studies - x-rays and phonocardiography.

Treatment of pathology

People with MVP do not always need drug therapy. Treatment measures depend on the severity of the disease and the severity of its symptoms.

If a person is not bothered by any, even minimal symptoms and the pathology does not progress, he can do the same work and lead the same lifestyle as healthy people.

Young men with mild MVP can be recruited into the army. Such people are recommended to exercise with the exception of professional sports.

If the cardiologist sees the need for treatment, he will prescribe conservative therapy. As with other heart diseases, doctors use several groups of heart medications:

sedatives (normalize the functioning of the autonomic nervous system);
beta blockers (taken for arrhythmia, in particular tachycardia);
anticoagulants (help fight the formation of blood clots);
drugs for myocardial nutrition (improve the functioning of the heart muscle, supply it with oxygen).

A patient with grade 1 mitral valve pathology does not require surgical intervention.

Prognosis and complications

As mentioned above, progression of the disease can lead to stenosis and insufficiency of the heart valves.

The initial stages of the pathology do not lead to serious disturbances in the functioning of the heart, however, they can develop into more severe forms. With grade 3 mitral valve prolapse, death is possible.

WITH Among the complications of MVP it is also necessary to highlight:

stroke (bleeding in the brain, which is provoked by high blood pressure when the walls of the blood vessels in the head are weak);
heart rhythm disturbances (occurs due to lack of oxygen supply to the heart);
endocarditis (inflammation of the inner lining of the heart vessels).

As you can see, pathological phenomena in the cardiovascular system are interconnected and entail other, even more severe disorders. Therefore, a prognosis can be given only based on the general state of health.

Prevention

L The best prevention for MVP is the timely detection and treatment of heart diseases that can lead to this disease or complicate its course.

Patients with congenital mitral valve defects should adhere to the correct work and rest schedule, give up bad habits, and eat a balanced diet.

People with a mild form of pathology can play sports, but not professionally. Physical activity must correspond to the body's capabilities. You should not overwork your heart, which cannot be called completely healthy.

If the clinical picture does not allow you to live fully, physical activity should be reduced, but it should not be completely abandoned. Such patients are recommended physical therapy, selected by a doctor.

Article publication date: November 25, 2016

Article updated date: 12/18/2018

From this article you will learn: what is stage 1, its causes and symptoms. Treatment and prognosis for the disease.

Mitral valve prolapse (abbreviated MVP) is the most common congenital or acquired pathology of the structure of the heart valve apparatus. This is a deflection (sagging, sagging) of one of the valves during the period of heart contraction, which can be accompanied by the reflux of blood back into the atrium.

If, according to an ultrasound of the heart, the valve fails by 3–6 millimeters, then they speak of prolapse (or defect) of the 1st degree. If this situation is accompanied by reflux of blood back into the left atrium, then they speak of grade 1 mitral valve prolapse with grade 1 regurgitation.

Prolapse occurs in men in no more than 2.5% of cases, and in women about 8% - this is data among all people with.

In the older age group of women, the prevalence of prolapse is 4 times lower. In women, this defect goes away with age; for men, the incidence rate of the pathology remains within 2–3%.

Patients with this diagnosis are treated and monitored by: a cardiologist, an arrhythmologist, a cardiac surgeon, and a neurologist.

Briefly about the anatomy of the valve apparatus

Understanding the mechanism and causes of prolapse is impossible without knowledge of the anatomy of the valve apparatus. The mitral valve consists of two leaflets: anterior and posterior; chords and papillary muscles.

Prolapse most often occurs on the posterior leaflet, a little less often on the anterior one, but the symptoms are always similar. For this pathology, it makes no difference which of the leaflets bends into the left atrium.

From the valves there are chords, which pass into the papillary muscles and are fixed from the inside of the cavity of the left ventricle to the walls. The valves are covered with connective tissue.

Parameters based on which the degree of prolapse of the posterior leaflet of the mitral valve is determined

Causes of pathology

The causes of the development of the defect are congenital and acquired.

Congenital causes

Anomalies in the development of connective tissue (Marfan and Ehlers-Danlos syndromes). This situation is genetically determined.

There are familial cases of pathology. In such families, all related members have this diagnosis confirmed.

Acquired reasons

The most common cause of mitral prolapse is rheumatic defects. Rheumatism is an autoimmune pathology that leads to a change in the appearance of the valves and the development of prolapse and (or) stenosis - narrowing of the mitral valve opening.

In rheumatism, they speak of a combined mitral valve defect, in which regurgitation (backflow of blood into the atrium) can prevail over stenosis.

Characteristic symptoms of prolapse

The complaints made by patients with grade 1 MVP without reverse blood flow into the left atrium (that is, without regurgitation) are very nonspecific. More often they are scanty, that is, nothing bothers the patients.

Symptoms appear when regurgitation develops, that is, blood flowing back into the atrium.

The disease does not interfere with the normal rhythm of life, unless the cause is myocardial infarction or infective endocarditis of drug addicts.

What are the symptoms of grade 1 mitral valve prolapse with regurgitation:

1. Heart symptoms

Pain in the heart area, short and short-lived.
Rhythm disturbances, which are accompanied by an increase in heart rate. The symptom is characteristic of congenital pathology.

2. Non-cardiac complaints

Non-cardiac causes are associated with disruption of the nervous system.

Increased sweating.
Panic attacks. These are attacks of fear that frighten a person (accompanied by an uncontrollable increase in heart rate, sweating, and redness of the skin).
Shortness of breath during exercise. It is important to understand that shortness of breath in this case is not a problem, but does not arise from nervousness. This symptom is found in half of patients
Decreased blood pressure (hypotension), which is accompanied by fainting and presyncope. The symptom is observed in 10–15% of patients among all patients with grade 1 mitral valve prolapse.

Treatment methods

For grade 1 mitral valve prolapse, the following are used: restorative measures (daily routine, hardening, physical activity), medications, and possible mitral valve replacement surgery.

What medications are used:

Depending on the cause that led to mitral valve prolapse (we discussed them above), doctors choose treatment tactics:

If the cause of prolapse is rheumatic disease, then prevention is needed, which is carried out by rheumatologists in the off-season so that damage to the mitral valve does not worsen.
Infection on the mitral valve leaflets is treated with antibiotics. The disease can be completely cured, the prolapse will go away, and there will be no regurgitation.
Blunt trauma (a blow to the chest with a fist or a blow to the chest at high speed against the steering wheel of a car) can lead to separation of one of the chords of the mitral valve leaflet. Then there will also be PMK. Doctors operate on these patients - they sew on the chord. The valve stops falling into the left atrium and the disease goes away.
In case of hypertension (high blood pressure), myocardial infarction (death of part of the myocardium), complex treatment of these diseases is carried out.

Forecast

The prognosis greatly depends on the cause that caused the disease.

For hypertension, the prognosis depends on the underlying disease and the severity of heart failure.
Rheumatic mitral defects have been observed for a long time (maybe a year or decades). They can go years without bothering a person. And if complaints arise, doctors prescribe medications. Medicines are taken in courses (a month or two) throughout life. When medications are ineffective, surgery is recommended - mitral valve replacement (an artificial heart valve is sewn in place of the mitral valve).
Infective endocarditis can be completely cured even conservatively. The treatment is long - months. The prognosis is good.
Treatment for drug addicts with infective endocarditis has a very short-term effect. Mortality is extremely high, even after MV replacement surgery. Only a few survive for the first two years. The prognosis is bad.

Mitral valve prolapse itself (without complications) has a good prognosis.

Mitral valve prolapse is one of the most common pathologies of the cardiac system. The essence of the disease is that the blood that comes from the ventricle to the heart returns back.

The halves of the valve, closing during contraction of the cardiac ventricle, enter the aorta. Many patients are concerned about the question: what is the danger of mitral valve prolapse?

The mechanism of development of the disease

In order to understand the mechanism of development of the disease, you need to know how the human heart works. Oxygenated blood enters the left atrium from the lungs and is then pushed out into the left ventricle.

When it contracts, blood flows under pressure to the right atrium and right ventricle. The blood has already given up all the oxygen, which goes to all the internal organs and tissues of the body.

At this stage of blood circulation, the blood is already saturated with carbon dioxide. From the right ventricle, the blood flow is directed to the artery of the lungs, where it is again enriched with oxygen.

With normal functioning of the heart, at the moment of contraction of the atrium, blood no longer returns back. This process is prevented by the mitral valve of the heart, the valves of which close tightly. With prolapse, the halves of the valve bend and sag. As a result, they cannot close tightly enough. This leads to the fact that not all blood enters the aorta. Part of it returns back to the left atrium.

The process of reverse blood flow is called regurgitation in medicine. When the valve halves are bent by 3 mm or less, the blood does not return back.

MVP is a dangerous disease that is accompanied by serious consequences. If the course of treatment is incorrectly chosen or absent, the death of the patient is inevitable.

Classification

Based on the volume of blood that returns and the level of deflection of the valve halves, prolapse is divided into several types:

According to the time of development of prolapse, the disease is divided into the following types:

Primary. It can be either acquired or congenital.
Secondary. It manifests itself in the form of various heart diseases associated with changes in the structure of the connective tissue of the inner walls of the heart lining.

When diagnosing this pathology, an extremely important point is to accurately determine the degree and type of its development.

The choice of the most effective treatment methods depends on this.

Symptoms

When a diagnosis of MVP is made, the patient experiences virtually no symptoms.

Only in the later stages of the disease may the following signs of illness appear:

sensation of pain behind the sternum - about 55% of patients feel them. As a rule, pain is localized in the left half of the chest. There is no connection with a person’s emotional state or physical activity and pain. They can be either short-term or last throughout the day.
A person may feel discomfort both at rest and during exercise;
feeling of lack of air - the patient feels that he does not have enough air, and he takes a deep breath;
disturbance of the rhythm of the heart contraction - it can beat very quickly or too slowly;
dizziness;
fainting;
severe headaches;
causeless increase in body temperature.

If one or more symptoms appear, you must immediately contact a specialist and undergo an examination.

Complications

Mitral valve prolapse: what is it dangerous? This question worries almost everyone who has problems with their heart function. In most patients, the disease is asymptomatic and does not affect their general condition. But 5–10% of people suffer from the development of complications that appear along with prolapse. Among the most complex and frequently encountered are the following:

From all of the above, we can conclude that the consequences of mitral valve prolapse can be quite serious.

If we talk about disease prevention, it consists primarily of periodic medical examinations. Even secondary MVP can occur without visible symptoms.

A diagnosis can only be made after a thorough examination. Only in this case can a diagnosis be made at an early stage of prolapse development and serious complications, and possibly death, be avoided. Attentive attitude to your body and organism is the key to health.

Valve prolapse is a fairly common, but most often harmless disease associated with improper formation of valves. This pathology consists of protrusion of the valve leaflets. The most commonly diagnosed type of such anomaly is mitral valve prolapse.

Doctors say the main cause of this disease is insufficient strength of the connective tissues of the heart valves. The anomaly is congenital.

Main symptoms

Most often, the anomaly does not manifest itself in any way, but some people may feel:

periodic chest pain;
attacks of general weakness;
dizziness;
signs of arrhythmia.

The course of the disease is generally favorable. Special therapy is usually not required.

As a rare manifestation, some patients have minor cardiac abnormalities and heart valve insufficiency.

An even more rare occurrence is severe forms of prolapse. In this case, a serious course of drug treatment is required, and often even surgical intervention.

The structure of heart valves

For the heart muscle to function properly, movable valves, called valves by doctors, are necessary.

In simple language the explanation goes like this:

Dampers consist of a number of elements. These are peculiar valves, the task of which is to block the holes in order to prevent blood from flowing from one part of the heart to another at certain moments.

They control the flow of blood.

The heart is a primitive “pump” designed to pump nutrient-rich fluids. The pump can only work if there are valves that allow blood flow in one direction and do not prevent it from returning back.

The heart muscle contracts rhythmically, thereby creating pressure that pushes blood out of it. The valves open when contracted. Then there is a brief moment of muscle relaxation, which reduces the pressure in it. In this case, the valve closes, and the blood does not flow back.

How many heart valves does a person have and what are they called?

Mitral valve. Its location is the junction of the left ventricle and the left atrium. The valve contains anterior and posterior leaflets. They are connected to the wall of the left ventricle by tendon strands called chordae. The chordae are also attached to the so-called papillary muscles. If they are in the position, then there is no gap left in the mitral valve leaflet. Then it is impossible for them to sag or come out at all. The main task of the valves is to prevent the blood flow from reversing. Mitral valve prolapse is called

the process of protrusion of one or both leaflets into the cavity of the left atrium. An incomplete, loose closure occurs. Part of the ejected blood, due to an anomaly, returns back. Prolapse of the anterior leaflet of the mitral valve is the most typical phenomenon of this kind.

Tricuspid valve. It separates the right ventricle and the right atrium. Its functionality is similar to the mitral valve.
Aortic valve. Location: area between the left ventricle and the aorta. The job of the aortic valve is to prevent blood from flowing from the aorta into the left ventricle.
Pulmonary valve. It connects the right ventricle of the heart and the pulmonary trunk. This valve prevents blood from returning from the lungs to the right ventricle.

For the manifestation of prolapse, the time factor is important.

Primary valve prolapse

This is a congenital anomaly that depends on a genetic factor and is transmitted to the child from the parents. This is usually an inherited defect in the connective tissue of the heart valve leaflets or chordae tendineae (the medical term is myxomatous degeneration).

Secondary valve prolapse

This type of prolapse is classified as an acquired anomaly, formed for various reasons.

Most often, these are consequences from such negative factors as:

chest bruises;
history of rheumatism;
myocardial infarction and a number of other reasons.

The valve leaflets may sag directly into the atrium. A common reason for this is inflammation or rupture of the chordae.

Signs

As a rule, the course of congenital forms of prolapse of the tricuspid valve, aortic valve and pulmonary valve is asymptomatic. The disease is most often discovered during the examination period due to other complaints.

Note. Congenital prolapse does not lead to significant disruption of proper blood circulation. Special treatment in the presence of such an anomaly is not prescribed.

The most common of all the defects listed above is mitral valve prolapse.

Typically, the course of a congenital disease is not accompanied by vivid and painful symptoms.

A small number of patients have the following symptoms:

Heart function intermittently. As a rule, this is a feeling of “freezing”, a rapid or slow heart rate, and irregular contraction of the heart muscle.
Periodic pain in the chest, either stabbing or aching in nature. Unpleasant feelings that cause discomfort sometimes last for several hours. The pain syndrome manifests itself with or without exercise, during rest hours, and does not subside even after taking nitroglycerin. Psychological pressure and prolonged stress can be a provoking factor.
Feeling of lack of air.
Fluctuations in body temperature.
Pain in the abdominal area, as a pronounced symptom of irritable bowel syndrome.
Pain in the head, sometimes accompanied by dizziness.
Pre-fainting and fainting state, especially in a confined space with a lack of air or as a result of nervous overstrain.
An unjustified feeling of fear.
The appearance of bruises.
Bleeding from the nose.
For women, it is also painful and prolonged menstruation.

The symptoms are due to the abnormal structure of collagen fibers.

In some cases, the following factors indicate primary mitral valve prolapse:

The person is too tall.
Elongated upper and lower limbs.
Excessive thinness and elasticity of the skin.
Elongated, thin facial features.
Increased motor capabilities of joints.
Some problems related to vision.

These symptoms are divided into a number of separate syndromes. We are talking about hereditary diseases. Some of them develop together with valve prolapse. In such cases, diagnosis is necessary to exclude Klinefelter syndrome or Marfan syndrome.

Signs of acquired mitral valve prolapse

Signs of the disease directly depend on the cause of its occurrence:

Secondary prolapse sometimes develops against the background of myocardial infarction. As a rule, these are sudden manifestations of a number of characteristic signs along with the symptoms of myocardial infarction. List of symptoms: severe pain in the chest, shortness of breath, disturbances in the rhythm of heartbeats, dizziness, sudden loss of consciousness, coughing attacks, the appearance of pink foam from the mouth. All of these symptoms are a compelling reason to immediately seek emergency medical help. Delay in effective competent treatment is fraught with the risk of death for the patient.
The second possible reason for the development of an acquired defect is the infliction of severe or moderate trauma to the chest area, if such an action leads to rupture of the chordae, which regulate the process of opening and closing the valve. In this case, the heart rate may increase, there may be a feeling that the heart is not working properly, shortness of breath and coughing attacks with pink discharge. Such symptoms should be the basis for calling emergency medical help.
Secondary mitral valve prolapse sometimes develops due to rheumatism, which often leads to inflammation of the connective tissue in the heart valve. The disease is characterized by slow and sluggish development with symptoms such as increased fatigue, shortness of breath after walking or minor physical exertion, and impaired heart function.

In order to have an accurate idea of the degree of mitral valve prolapse, the patient necessarily needs a diagnostic procedure such as echocardiography. The level of sagging of the valve leaflets into the cavity of the left atrium is taken into account.

Characteristics of three degrees of prolapse:

1st degree

The sagging into the cavity of the left atrium is less than five millimeters.

2nd degree

Sagging by six to nine millimeters.

3rd degree

Sagging by ten or more millimeters.

Note. Please note that this classification is used only by doctors in the Russian Federation and in a number of post-Soviet countries. Please also note that the degree of prolapse is not an accurate reflection of circulatory problems. Therefore, first and second degree mitral valve prolapse usually does not significantly impair blood flow and in most cases does not require medical intervention.

Should I be afraid of complications with such a defect?

Possible negative complications:

Improper closure of the valves causes blood to enter the atrium cavity. Sometimes heart failure is a consequence of severe development of mitral valve insufficiency.
There is a risk of infective endocarditis. We are talking about inflammation of the inner lining of the heart. You should pay attention to the following symptoms - changes in body temperature, weakness, pain in the joints, irregular heartbeat, signs of jaundice, a network of pinpoint hemorrhages on the skin.
Signs of arrhythmia are felt, dizziness and fainting are possible.
The risk of sudden acute disruption of blood supply to the brain increases. A stroke carries the risk of serious consequences, including death. Such a risk should be excluded, especially for people over fifty years of age.

How does mitral valve prolapse manifest in children?

For children, heart valve defects of the primary type (disturbance in the structure of connective tissue) are most common. Symptoms of the disease are sluggish or absent altogether. Usually these types of abnormalities are discovered during examination for other medical problems.

Signs of mitral valve prolapse in children and adults

Symptoms in children and adults are practically no different. This disease belongs to the list of minor anomalies of heart development. Such pathologies, as a rule, do not interfere with the child’s ability to fully engage in studies, rest and play sports.

However, there is a risk of developing arrhythmia or a number of other complications, so children with such anomalies are referred for regular preventive examinations and consultations in the cardiologist's office.

What should pregnant women do if they have mitral valve prolapse?

This type of anomaly in the heart valve of a pregnant woman cannot cause significant harm to her or her child. There should not be any special complications during pregnancy and childbirth.

Children born to a mother with valve prolapse are no different in body weight and developmental ability from those children born to absolutely healthy mothers. Babies are born on time and in the vast majority of cases without specific problems.

Note. If you are planning a pregnancy, be sure to undergo examination using a special, very informative, simple, painless and affordable test - echocardiography (ECG).

Make sure that the volume of blood that is returned back in the full circulation cycle is normal. Find out the severity of mitral valve regurgitation if you have it. Negative consequences from such anomalies are extremely rare, but this does not mean that you should not consult a specialist about them.

Help for patients with heart valve abnormalities is necessary in the following cases:

Sharply deteriorating health, manifested in weakness, shortness of breath, “bubbling” breathing and foaming at the mouth. Such symptoms indicate the return of a large part of the blood flow to the left atrium. Regurgitation can lead to pulmonary edema.
Sudden loss of consciousness, which is possible due to insufficient blood flow to the brain (due to malfunctions of the heart muscle), which also indicates arrhythmia.
Increase in temperature.
Joint pain.
Feeling weak, which may indicate infective endocarditis. This is a fairly serious complication of valve defects.
Inability to concentrate when performing work functions.
Signs of pronounced fatigue, even if there is no reason for this.
Problems with respiratory function with minor physical exertion.

Important. All of the above signs may be the basis for the need for a comprehensive examination of the patient to detect possible heart failure.

Diagnostics. When should you do research?

Symptoms indicating heart valve prolapse require a more specific diagnosis from your doctor (usually a general practitioner) and a cardiologist. The patient may need an examination of the heart and cardiovascular system as a whole, as well as additional diagnostics from a neurologist or other related specialist.

In medical practice, a wide range of modern effective methods for diagnosing the mitral valve is used:

Echo-CG and Doppler echocardiography make it possible to speak with sufficient accuracy about the degree of mitral valve prolapse, detect insufficiency of this valve and its degree of development, and determine the level of blood entering the atrium.
Electrocardiography provides a picture of a number of functional heart disorders, which sometimes indicates mitral valve prolapse. We are talking about arrhythmia, an increase in irregular contractions of the heart muscle, etc.
An ECG (Holter) makes it possible to monitor the functioning of the cardiovascular system over a long period (for example, a day). Electrodes are installed on the subject's chest, which “record” information and transmit it to a small recording device. Throughout the day, the patient behaves as usual, excluding bad habits. This technique provides the most complete characterization of the work of the heart.

Effective therapeutic measures to eliminate all risks from mitral valve prolapsus

Congenital prolapse is a disease that usually does not require special medical intervention.

In what cases is prolapse treatment necessary?

Pay attention to these symptoms:

Disturbed rhythm of heart beats, which indicates tachycardia and arrhythmia.
A number of recurring disorders of the autonomic system. We are talking about unpleasant and painful sensations in the heart area, dizziness and fainting.
Signs indicating severe mitral valve insufficiency.

The necessary measures for the treatment of heart valve anomalies are determined only by a medical specialist, taking into account the individual factors of the patient.

Mitral valve prolapse and medications to restore health:

Some drugs from a number of adrenergic blockers are recommended for rapid heartbeat (tachycardia), as well as to prevent the development of arrhythmia.
A number of drugs containing magnesium help fight dizziness and fainting, and relieve pain in the heart muscle area. Magnesium helps stabilize temperature, the functioning of the nervous system and the process of sweating.
A number of vitamins, including group B and PP.

Such an operation is prescribed only by a certified experienced specialist, based on medical history, examination materials of the patient and his individual characteristics.

Surgery is usually prescribed for identified and pronounced valve insufficiency. If the patient experiences symptoms indicating major regurgitation, the mitral valve is replaced with a special prosthesis.

When prescribing treatment and taking effective medical measures to eliminate functional problems of the mitral valve, the causative factor and the degree of regurgitation of the blood flow must be taken into account.

If the patient is confirmed by examination to have significant mitral regurgitation, indicating a large volume of blood returning to the atrium, he will require surgery.

Please note that the following tips will be useful for all people with signs of congenital mitral valve prolapse:

Careful oral hygiene. This means that the patient needs to brush his mouth two to three times a day, and also use high-quality dental floss. You should visit the dentist's office at least twice a year. Such precautions are not at all unnecessary, because we are talking about reducing the risk of infective endocarditis. This is a very dangerous complication, possible due to valve defects.
Complete or at least partial cessation of a number of bad habits, especially drinking alcohol, coffee drinks and smoking tobacco products. Thanks to this restriction, you will significantly reduce the risk of functional disorders of the cardiovascular system, including tachycardia and arrhythmia.
Reducing physical stress on the body and psychological pressure on the nervous system.

Note. Modern medicine does not adhere to the outdated opinion that sports games and physical labor certainly cause irreparable harm to people with heart valve abnormalities. On the contrary, they need moderate loads in order to maintain the heart in proper tone.

Admission of children with mitral valve prolapse to physical education lessons

Only a specialist doctor has the right and proper competence to resolve this issue. To make a verdict, he must accurately assess all possible risks and individual characteristics of the child. It is also necessary to exclude all negative chances of possible complications.

For most children with symptoms of complicated mitral valve prolapse, physical exercise, swimming, and aerobics are not only acceptable, but also useful.

As for admission to professional sports, this is an individual matter. In any case, such a decision requires a consultation of medical specialists including a psychologist.

Since the problems of cardiovascular diseases are closely related to the state of the nervous system, special attention should be paid to this fact.

A child with problems with the functionality of the heart valves should be protected from psychological pressure and stress. This also applies to adult patients to a large extent. Please note that mental stress on the nervous system is one of the main factors in the emergence of a number of complications.

Doctors have long known that a person’s mental attitude largely determines his health and comfort of living in any conditions.

A positive attitude, friendliness, love for yourself and loved ones is the only way to the world of harmony, peace and happiness.

Take care of yourself and respect the living space of the people around you. Health is a closed island of your being. This is a collective work in the name of improving the perception of reality.

Conclusions. Mitral valve prolapse most often does not pose a serious threat to health. However, if such a pathology is detected, you should undergo regular examinations, be observed by specialists and follow their recommendations.

We try to provide the most relevant and useful information for you and your health.