Mitral Valve Prolapse is not a life-threatening condition and usually, go unnoticed. When the symptoms turn severe, doctors request to perform diagnostic tests. The diagnosis is based on routine physical examination, stethoscope, and sounds such as murmur or whooshing sound (which occurs because of stretched valve flaps). The doctors perform other tests to confirm the MVP such as Echocardiography, Doppler Ultrasound, chest x-ray or electrocardiogram. Echocardiography provides the size and shape of the heart, its chambers and valves. Doppler Ultrasound provides the speed and direction of flow of blood. Electrocardiogram shows the heart rhythm and irregular heartbeats.[1] Mitral Valve Prolapse when diagnosed doctors work to treat symptoms and depending upon the patient’s condition cardiologist perform surgery to repair or replace the valve.
What Are The Complications Of Mitral Valve Prolapse?
If left untreated mitral valve prolapse can lead to following complications
Mitral Regurgitation. This is the most common complication of mitral valve prolapse. Mitral regurgitation may happen due to acute conditions such as ruptured chordae tendineae causing failure of mitral valve leaflets or chronic mitral valve prolapse.[3] People suffering from Mitral Valve Prolapse with Mitral regurgitation can lead to congestive heart failure, infective endocarditis, and atrial fibrillation (AF) with thromboembolism.[2]
Congestive Heart Failure. The condition arises as the heart is unable to pump blood as per the body demands. The heart has to work hard to allow sufficient flow of blood. The amount of blood pumped with each heartbeat is reduced when compared to the normal because of leaky valve. The heart muscles become weaker with time resulting in heart failure. The pressure builds up inside the body resulting in fluid accumulation in the lung. This, in turn, causes stress in the right part of the heart.
Atrial Fibrillation. The impaired functioning of the mitral valve can result in stretching and enlargement of your heart’s left atrium. This results in an irregular heart rhythm in both the atria. This atrial fibrillation can cause blood clots to detach from the heart muscles and get transported along with the blood to other parts of the body.[4] This can be a life-threatening condition resulting in stroke when the clot travels to the brain.
Pulmonary Hypertension. If mitral valve prolapse remains untreated for a long duration and the mitral regurgitation remains unattended, this can develop high pressure in the lungs resulting in pulmonary hypertension. There will be increased pressure on both the sides of the heart causing the heart to develop pulmonary hypertension which eventually leads to heart failure.
Endocarditis. Infective endocarditis (IE) or bacterial endocarditis (BE) is caused by the bacteria which get deposited in the heart lining, blood vessel or heart valve. People who have mitral valve prolapse remains untreated for a long duration and the mitral regurgitation remains unattended, this can develop high pressure are at greater risk of infection as the deformed valve attracts bacteria which gets deposited in the valve causing infection. The dental problems such as gum infections and tooth decay can cause the bacteria to reach the bloodstream via brushing and eventually land in the heart valves and the endocardium. Patients who had history of endocarditis are given antibiotics before performing any dental procedures to avoid the risk associated with it.[5]
People who have birth defects of the heart are at greater risk of developing endocarditis.
Conclusion
Mitral regurgitation is the most common complication of mitral valve prolapse. A number of factors such as increased pressure in the left atrium because of the leaky valve and pulmonary hypertension because of the pressure on the right atrium can result in congestive heart failure. Mitral valve prolapse should be attended immediately after symptoms and diagnosis confirmation to avoid complication of the disease leading to congestive heart failure. The other complications if mitral valve prolapse remains untreated for a long duration and the mitral regurgitation remains unattended, is that this can develop high pressure are atrial fibrillation and endocarditis. There will be palpitations, increased heartbeat and heart works harder to pump the blood resulting in shortness of breath even at rest. People undergoing dental procedures should be given antibiotics before procedures to reduce the risk and complications.
- https://www.mayoclinic.org/diseases-conditions/mitral-valve-prolapse/diagnosis-treatment/drc-20355452
- https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/problem-mitral-valve-regurgitation
- https://www.ncbi.nlm.nih.gov/books/NBK553135/
- https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/symptoms-causes/syc-20353159
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985400/
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