Generally speaking, mitral valve prolapse can certainly be associated with chest pain that has not been well defined as to why this occurs. Shortness of breath can certainly be attributable to mitral valve reurgitation. The degree of regurgitation, along with other well defined variable (one of wich is pulmonary hypertension) and symptoms help make the decision of when mitral valve surgery is indicated. Exercise testing with a echocardiogram is an excellent way to test to see what happens when you exercise (if the regurgitation increases, if the pulmonary pressures increase, and it also defines exercise tolerance). Symptoms are always important, especially if they are associated with more severe mitral regurgitation. Mild regurgitation, associated with symptoms or not, incurs no change in prognosis.