classic mitral valve prolapse

[UFGators]

I am a 22 y/o male who was diagnosed with classic MVP about a year ago after going to the doctor for what turned out to be persistant PAC's. My echo report showed mild mitral leaflet thickening (myxomatous degeneration) with a mild prolapse of the posterior leaflet. Doppler study showed mild MR. My EF was 45-50% (the cardiologists does not know why it is lower than it should be and he really didn't seem to care). He sent me for a CT of my aortic root because he thought it might be enlarged. The CT came back fine (root was 2.5) and the cardio said that it is hard to measure sometimes with just an echo. I have been back to the cardiologist several times to ask him questions about MVP and he just gives me answers to reassure me that I am OK. He is treating me like I have some sort of anxiety disorder when in reality I just wanted to know if I am OK to run and lift weights like a normal 22 y/o and what percentage of people with classic MVP have serious problems (sudden death). A friend of mine from work ironically died suddenly a few months ago and the only cardiac problem they could find was a "abnormal mitral valve." I feel like no doctor is telling me the truth about my risks and they are so used to thinking that sudden death is a rare complication because that is what they were told to say in the '80's when they though 20% of the population have it. After learning of my friends death I read a few journal articles that said that ~4000 people in the US die suddenly each year due to classic MVP. If this is true that is a lifetime risk of over 10% for these people. I know you deal with a lot of mitral valve questions so I appreciate your time in answering mine. I am just looking for honest answers about my risks for complications.

[miami987]

Would that be considered a structurally normal heart? I was given the same diagnosis. I'm not sure if I have "Classic MVP". Just that my cardiologist said "Don't worry. you have a variation of a normal heart. This is nothing. You can lift weights and go run a marathon if you want."  

I was also very concerned about the diagnosis. Funny thing is they can never hear a murmur or click when they listen to my heart, it just showed up on the echo. Overall, I would not worry about this. I have met many people that have this and are very active. I go surfing, run 3-5 miles, mountain bike some pretty hardcore stuff, etc. I'm 32 yo, Male. I do avoid heavy weightlifting because I dont think its good even for completely normal hearts.

[Michael J. McWilliams, M.D.]

The classic quote is that there is a 1% per year risk in someone with severe mitral regurg waiting for surgery.  If you have MVP with no significant MR, the recommendation is still no intervention.  I think you might be over analyzing things.

There really aren't that many choices
-- surgery is not an option because you can't fix a valve that doesn't leak that much
-- the risk for sudden death is WAY to low for an ICD
--PACs in a structurally normal heart do not increase the risk of death

The question you need to ask yourself is what will honestly make you feel better -- your doctor has already reassured you that you are low risk for cardiac events.  Your risk is very low.  One way that I like to look at it is not to worry about risks that we cannot change -- in this is one of them.

I hope this helps.