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What exactly is mitral valve prolapse? Iím 51 year old female, and my doctor said I had a degree of severity of one over six. What would be the significance of that and what could be done about it?

MVP is a common disorder and it is usually congenital in nature. Anywhere between 3 to 8 % of female population and perhaps half as many males are born with this problem. In most people it will remain silent and cause no side effects their entire life. The mitral valve separates the left ventricle from the left atrium, and in these individuals is large and has redundant tissue. This may set the stage for leakage of the valve, usually slowly progressive over the life time. In many individuals there is no leakage whatsoever or it is very minor, and thus may be graded on a scale of 1 to 4 in severity. A score of 1 over 4 would be minor leakage of the valve on an echocardiogram. Your doctor may have heard a murmur which was very soft and often judged on a scale of 1 to 6. Again this would imply a soft murmur and small amount of leakage. In some individuals the leakage becomes very severe and requires valvular repair or replacement. This deterioration occurs in minority of patient and most common in older women. Of all the patients with mitral valve prolapse less than 5% will ever need valvular surgery.

This disorder tends to run in families, being more prevalent in taller, more slender women. It may also cause myriad other symptoms including palpitations, chest pain, fatigue, exercise incapacity, shortness of breath, and episodes of fainting. These symptoms usually occur in the absence of severe valvular leakage, remaining somewhat a medical mystery, unexplained on any defined physiologic basis. These valves can also be infected, particularly at the time of dental work or when one has skin infections. The use of prophylactic antibiotics may be necessary to prevent this serious problem. It is important to know whether one has mitral valve prolapse and to know the severity. An anatomic configuration on the echocardiogram and the degree of leakage will determine whether preventive antibiotics are necessary, and also provide insight into the potential need for valvular surgery.

At age 51 with only minimal leakage it has been my experience that rapid deterioration is unlikely and that your prognosis is very good. Long term follow up with your doctor is important, the role of serial echocardiograms to be decided by your cardiologist.


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