What are the complications of mitral valve prolapse?
Complications are uncommon in the average patient with this condition. Most MVP sufferers, even those with symptoms, can lead normal lives and have life expectancies similar to those who do not have the condition.
Complications can occur, however, sometimes very suddenly, and they can be serious. When they do occur, it is normally in middle-aged or older adults and those with a murmur during systole (the contraction phase of the cardiac cycle), thickened leaflets, and enlarged upper left atrium or lower left ventricle.
What are the most common mitral valve prolapse complications?
The main complication of MVP is mitral regurgitation. With regurgitation, blood leaks back into the left atrium during systole. When severe, blood can accumulate in the atrium and lungs. The left ventricle can become enlarged and/or damaged, which can cause congestive heart failure and other complications. Mitral regurgitation can be acute or chronic, the first being a medical emergency.
Another complication of mitral valve prolapse is cardiac arrhythmia. People with arrhythmias experience rapid, slow, and irregular heartbeats. These can be bothersome and deadly, and they tend to surface when there is regurgitation that is severe. Atrial fibrillation, especially, is a common heart rhythm abnormality and mitral prolapse complication.
With atrial fibrillation, electrical impulses from the sinoatrial node (the heart’s pacemaker) are overcome by chaotic pulmonary vein impulses. As a result, blood collects in the atria and isn’t pumped into the ventricles smoothly and completely, generating a wild heartbeat. This can cause symptoms like palpitations, breathlessness, chest pain, and fatigue. It can also lead to clotting, stroke, heart failure, and death.
Note: While atrial fibrillation is more common as a complication of MVP, ventricular arrhythmias are more likely to cause sudden cardiac death. Sudden cardiac death in athletes has been a subject of much discussion and debate in recent years.
Infective endocarditis, sometimes called bacterial endocarditis, is yet another of the serious mitral valve prolapse complications. Endocarditis is an infection of the endocardium, a functional membrane that lines the heart’s chambers, valves, and innermost structures. The infection typically affects the heart’s valves, particularly those that are defective or damaged.
Endocarditis occurs when bacteria (or other organisms) travel through the bloodstream and attach to an atypical surface, usually a faulty valve, forming abnormal growths called vegetations. This can damage the valve, destroy the endocardium, and lead to heart failure, stroke, and death. Endocarditis is fatal if left untreated. Death can occur even with treatment, and treating it can be difficult.
Note: The mitral valve prolapse complications above (and others) occur with greater frequency in patients with regurgitation. The more regurgitation there is, the higher the risk of problems, generally. MR can be symptomatic or asymptomatic, and it can develop as a result of other conditions.
Are there any other mitral prolapse complications?
Yes, pulmonary hypertension and transient ischemic attacks.
Pulmonary hypertension is a condition in which blood pressure in the lungs’ arteries (the main pulmonary trunk and two smaller arteries) is higher than normal. Normally occurring in those with untreated regurgitation, it is typically caused by leaky valves that increase pressure in the left atrium. This places strain on the right atrium and ventricle, sometimes causing heart failure.
Transient ischemic attacks produce similar symptoms to a stroke. However, they generally last no longer than five minutes and do not result in permanent brain damage or death. TIAs are actually known as mini-strokes. They are also called warning strokes, as an actual stroke usually takes place within 12 months of a transient (temporary) ischemic attack.