Re: mitral valve prolapse

Posted By CCF-CARDIO MD HSB on September 02, 1997 at 09:40:39:

In Reply to: mitral valve prolapse posted by Lisa on August 21, 1997 at 22:46:58:







: I am a 27 yr old female diagnosed with mvp in 1994. I was told this was nothing to worry about unless i had certain procedures done, such as cleaning my teeth. I have a few questions. In the last 6 months I have had 3 different infections. The first was my throat..anitibiotics for 7 days. The second was a rash..never diagnosed..no antibiotics. The third was pelvic inflammitory disease, which is usually acquired thru stds, all of those test came back negative. My grandfather recently died, he was diagnosed a week prior with lung cancer, he had tb in the later part of the 40's(never treated), and his cause of death is questionable. I am concerned that the infections I keep getting are a result of something i may have contracted from him. I was only told this mvp was dangerous if I contracted an infection. He also had a serious staf infection 3 weeks prior to his death. I had an ekg ran about 4 weeks ago which showed an enlarged left ventrical. If you can lead me in the right direction it would be greatly appreciated. I dread having any more inconclusive tests run where I live. I lost faith in the medical field here after so many misdiagnosis of my grandfather. Thank you so much in advance. Lisa




























































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Dear Lisa:
     Mitral valve prolapse (MVP) is the most common abnormality of heart valves in the United States, affecting between 4 - 5% of adults.  Fortunately, the vast majority of people have few, if any symptoms and live a normal life.  However, a small percentage of people suffer from complications stemming from mitral valve prolapse, namely progressive dysfunction of the valve (mitral regurgitation), infectious endocarditis,  stroke, abnormal heart rhythms and sudden death.  
     Before we continue our discussion, a basic understanding of cardiac anatomy is essential.
     The heart is comprised of four chambers (the right atrium, left atrium, right ventricle, & the left ventricle) and four valves (tricuspid, mitral , pulmonic, & aortic) which regulate blood flow.  Blood flows from the body to the right atrium and then via the tricuspid valve to the right ventricle. The right ventricle pumps blood to the lungs for oxygenation.  Subsequently, blood flows from the lungs to the left atrium and via the mitral valve to the left ventricle. The left ventricle pumps blood to the rest of the body.  
     In mitral valve prolapse, the mitral valve is structurally abnormal. The valve prolapses into the left atrium when the left ventricle contracts.  The degree of abnormal function varies from minimal to a severely regurgitant ("leaky") valve. The vast majority of people have subtle structural abnormalities and therefore, little or no regurgitation and few symptoms.
     Doctors consider the diagnosis of mitral valve prolapse when they hear abnormal heart sounds and murmurs, specifically mid to late systolic clicks and late systolic murmurs. Often, if the findings warrant, an ultraound of the heart may be ordered.
     Further evaluation and any treatment is dictated by the degree of functional abnormality.  Basically if there is no significant regurgitation, the prognosis is excellent and patients are followed every five years for progression of disease. Mild to moderate regurgitation requires annual follow up and possibly treatment with medicines to control blood pressure.  Also since the valve is structurally abnormal antibiotics are prescribed prior to any dental and surgical procedures in order to prevent the valve from becoming infected.  Severe regurgitation requires aggressive medical treatment, frequent medical evaluations and possibly surgery.
     Lisa, from your description, it appears that your doctors have diagnosed you with mitral valve prolapse with minimal regurgitation.  It is important to abide by their instructions regarding antibiotics prior to any dental or surgical procedures.  Furthermore, continued medical follow up is necessary.  Rest assured that the vast majority of patients with the diagnosis of mitral valve prolapse do very well.  
     If you are seeking a second opinion or further evaluation, an appointment with one of our cardiologists specializing in valve diseases can be arranged by calling the Cleveland Clinic at [phone]. Dear Lisa: