How is mitral valve prolapse treated?
MVP treatment is not necessary in most cases. Most patients do not experience symptoms, or they are so mild that monitoring during routine medical checkups is enough.
Even those with mitral regurgitation and dysautonomia symptoms may still only need an annual evaluation. However, that doesn’t mean that MVP is totally benign.
When the condition involves significant regurgitation, the two main treatment options are medication and surgery. The least invasive choice is generally preferred, but the course of action depends on the severity of the case and on if the patient has other conditions that may increase the risk of complications. Sometimes, both drugs and surgical intervention are necessary to treat the condition.
Note: Pregnancy may intensify the symptoms of MVP. Women should discuss with their doctors whether or not any specific mitral valve prolapse treatment is necessary.
There are three goals when treating this disorder:
- Preventing infection (endocarditis) and complications.
- Relieving symptoms and discomfort.
- Correcting any physical underlying problem/s.
Which medications are used for mitral valve prolapse treatment?
When MVP symptoms or complications like regurgitation, atrial fibrillation, and congestive heart failure warrant the use of medication as a mitral prolapse treatment, various drugs may be prescribed to lessen discomfort and achieve a desired result. Many times, these will be prescribed as part of a long-term plan that requires taking a combination drugs that may include:
- Beta blockers – These can help to relieve the palpitations, arrhythmia, and chest pain related to MVP. They block the effects of epinephrine (adrenaline) and norepinephrine on the heart, so that it can beat more easily. They also dilate blood vessels, facilitating blood flow.
- Benzodiazepines – Benzos, such as Xanax, have a sedative effect on the body. This can help to relieve anxiety related to MVP. These drugs are commonly prescribed to patients who have symptoms of dysautonomia or mitral valve prolapse syndrome.
- Vasodilators – These prescription medications widen the blood vessels to enable blood to flow better and can lessen the amount of mitral regurgitation. Vasodilators may be necessary for patients who have chronic or acute regurgitation and an enlarged left ventricle.
- Blood thinners – Anticoagulants reduce blood clotting and the risk of complications. Those with a history of stroke, heart failure, or atrial fibrillation sometimes need these meds. A doctor may prescribe an over-the-counter type like aspirin or something stronger like Warfarin.
- Digoxin – Digoxin is useful in the treatment of regurgitation with atrial fibrillation. It helps to minimize irregular beats by slowing down heart rate. It is also used to strengthen heart contractions in those with a weak left ventricle, enabling the weakened chamber to pump blood more efficiently.
- Diuretics – Diuretics (water pills) relieve fluid retention (edema) in the legs and lungs, which can be a side effect/complication of mitral regurgitation. The accumulation of fluid is known to cause ankle swelling, fatigue, and breathlessness. It can potentially cause respiratory failure.
- Prophylaxis – Antibiotics can prevent infective endocarditis, a serious infection of the interior lining of the heart. Some patients with MVP (a small percentage – high-risk patients) need to take antibacterial medicines as a precaution before certain medical and dental procedures.
When do you need surgery with a mitral valve prolapse?
Surgery may be required when MVP produces severe regurgitation, symptoms, or complications, but the decision is complicated. Surgery always accompanies risks and shouldn’t be rushed into. However, even without symptoms, significant regurgitation can lead to heart failure, and procrastination can result in the heart being too weak or damaged to withstand treatment.
- Invasive – Most procedures involve open-heart surgery, where the surgeon enters the chest through the breastbone. This process involves weeks to months of recovery time, depending on the individual’s health status, physical reaction to the procedure, and other factors.
- Minimally invasive – Many surgeons now prefer advanced, less invasive methods, as this reduces blood loss, recovery time, risks, and complications. There are several ways to perform minimally invasive surgery, but, depending on the hospital, this may not always be an option.
- Repair – This option preserves the patient’s existing mitral valve. It decreases the risk of weakening the heart and subsequent infection. Unless other conditions warrant it, repair also means that patients do not need to take blood thinners for life. Repair surgery may involve shortening the chordae tendinae that connect the valve to the left ventricle, removing excess tissue from the mitral leaflets for proper closure, and removing calcium buildup or repairing holes and tears. It may also involve reattaching the cusps in proper alignment to the mitral annulus and repairing or tightening the annulus. Sometimes, the it is replaced with a prosthetic ring.
- Replacement – When repair isn’t a feasible mitral valve prolapse treatment option, surgeons use a biological valve or mechanical valve to replace the one that is damaged, both of which function as a real valve. Each type of valve offers its own advantages and disadvantages.
Types of valves:
- Biological valves – These are normally made from animal tissue, including pigs and cows. Sometimes, human tissue is used. With these valves, patients are less likely to need a lifetime of blood thinners and medications. However, they do deteriorate over time, so more surgery may be required later on in life. They generally last for over ten years.
- Mechanical valves – These are made from tough, lightweight substances like titanium and normally last a lifetime. The drawback is that patients must take anticoagulants or thinners every day for the rest of their lives, so that blood clots do not form around or on the artificial valve – this can cause a stroke. Mechanical valves are more prone to infection.
Whichever type of mitral valve prolapse treatment a person receives, when handled in timely fashion, the overall prognosis is good. Some patients experience complications, but most do not.
Are there alternative, non-drug treatments for mitral valve prolapse?
Yes. There are a number of natural treatment options that can make MVP symptoms more tolerable (or even eliminate them altogether) and decrease the risk of complications. Controlling blood pressure and promoting blood flow are two important goals with each solution, and they tend to work best in tandem. Alternative treatments for people living with the condition include:
- Eating right – Avoiding certain foods and stimulants can provide relief from the symptoms of mitral valve prolapse and prevent all kinds of complications. Staying hydrated and consuming salt (in moderation) can also be helpful. People with MVP should try to maintain a balanced diet.
- Exercise – Exercise is generally encouraged by medical professionals and can go a long way in treating the fatigue, palpitations, chest pain, dizziness, and anxiety associated with this disorder. Studies have shown that aerobic exercise, especially, can be beneficial.
- Supplements – Supplements like magnesium, l-carnitine, acetyl-l-carnitine, and co-enzyme q10 may provide symptom relief. B vitamins (b1 thiamine, b3 niacin, b6 pyridoxine, and inositol) can also reduce discomfort, along with kava, hops, and valerian.
- Cognitive therapy – People with MVP syndrome can benefit from psychotherapy. A good therapist can help their patient understand symptoms, identify triggers, and provide a treatment plan, showing sufferers how to break the mental response to what is felt physically.
- Relaxation – The benefits of relaxation are numerous. Activities like yoga, tai chi, meditation, and massage can lower blood pressure, slow the heart and breathing rate, improve blood flow, and reduce tension and pain. They can also reduce anxiety, depression, and stress.
Note: While supplements and herbs can be helpful, they can have adverse reactions with mitral valve prolapse medications. Furthermore, exercise may not be suitable for everyone with the condition. Always consult a doctor before taking a supplement or starting a new exercise program.