What are the symptoms of mitral valve prolapse?
Most people with the MVP condition do not experience any symptoms. Unless a doctor discovers it during a routine physical checkup, it could go undetected.
Listening with a stethoscope may reveal a click sound when the valve leaflets close improperly. A doctor could also detect a murmur, the sound of blood flowing back into the left atrium, the heart’s left upper chamber.
In a small number of cases, mitral valve prolapse can be symptomatic and deadly, particularly if there is evidence of progressive regurgitation. Regurgitation tends to be mild and develop gradually but can sometimes progress quickly, triggering a sudden onset of acute symptoms and complications. Patients who develop these should seek medical attention without delay.
Note: Symptoms can be problematic even in patients with a mild mitral prolapse, especially when the symptoms first become evident. Prescription drugs, lifestyle changes, and other forms of treatment can help to keep them under control, though, and they are usually manageable.
How do doctors identify the MVP click and murmur?
The murmur and click timing associated with a prolapsing mitral valve are different to other heart conditions.
The length of the murmur when standing versus squatting and with certain pressure-related maneuvers helps to differentiate the condition. The timing of the systolic click also changes, further distinguishing mitral prolapse from conditions such as hypertrophic cardiomyopathy.
For example, when standing, and during a test called the valsalva maneuver where a patient exhales with closed airways, the click occurs earlier in the systolic cycle and the murmur is longer. When squatting, the click comes later in the beat and accompanies a short murmur. The handgrip maneuver, which involves clenching a fist as tightly as possible for as long as possible, also shortens the length of the murmur, but it produces a mid-point click. This last type of systolic click is very common with mitral valve prolapse and is the most conclusive sign.
Other medical tests, such as echocardiograms, help to confirm the diagnosis. Beyond discovery during an examination, a variety of symptoms can indicate the presence of a prolapsing valve.
What are the mitral valve prolapse symptoms?
Symptoms can include:
- Chest pain or discomfort that feels dull, sharp, or like pressure. It can last for a brief moment or several hours. This pain is not related to a heart attack. But if there is any question, it is important to seek immediate medical attention.
- Irregular heartbeats (arrhythmias) or palpitations where the heart seems to skip a beat, beat too fast, flutter, or beat too hard. These classic mitral valve prolapse symptoms may occur more frequently when reclining on the left side.
- Fatigue, lightheadedness, and dizziness. Fatigue can occur after minimal exertion. MVP is sometimes mistaken for chronic fatigue syndrome.
- Trouble breathing (dyspnea/air hunger), either during physical exertion or when lying flat.
- Fainting or syncope is yet another of the MVP symptoms.
Note: in contrast with the overall population, symptoms like fainting, palpitations, and arrhythmias do not occur with significantly greater frequency in mitral valve prolapse patients. Roughly 11-15% of sufferers report difficulty catching their breath and moderate chest pain.
In addition to the symptoms above, other seemingly unrelated ailments have also been linked to MVP. These include anxiety, panic attacks, IBS, and symptoms of dysautonomia. Those who experience symptoms (about 40% of sufferers) are (were) said to have mitral valve prolapse syndrome.