Mitral Valve Prolapse

The mitral valve controls blood flow between the left atrium and the left ventricle. The left atrium is the chamber where the blood returns from the lungs after being oxygenated. It is then pumped through the mitral valve to the left ventricle, which pumps blood to the body’s organs and tissues. The mitral valve has two flaps called leaflets.

These leaflets are supported by thin cords similar to those that support parachutes, and prevent the valve from bulging in the opposite direction when the ventricle contracts. When the atrium contracts, the mitral valve opens to allow blood to flow to the ventricle. When the ventricle contracts, the mitral valve closes to prevent blood from flowing backwards into the atrium. When the mitral valve leaks do to not closing properly it is called mitral regurgitation.  A mild amount of mitral regurgitation is usually tolerable within normal physiological limits.  When the mitral regurgitation becomes moderate to severe is when concern is raised.

Mitral regurgitation is a condition where the valve between the heart’s two left chambers doesn’t close all the way, and allows some blood to flow backward. If it becomes significant, mitral regurgitation causes the heart to work harder and can lead to heart failure.

Symptoms of mitral valve prolapse

Most patients with mitral valve prolapse are non-symptomatic. But some patients do experience symptoms associated with mitral valve prolapse. These may include chest pain, palpitations, having dizzy spells or light-headedness, shortness of breath, and a feeling of panic or anxiety.

Treatment of mitral valve prolapse

Unless there is a murmur or bothersome symptoms associated with a leaking valve, no treatment is needed. The patient will most likely not have problems and will not need treatment. However, patients who have valves that leak will need to have periodic follow-up exams and echocardiograms to ensure that the leak is not worsening as that may lead to heart failure.  No medications have been proven to change the course of mitral valve prolapse or regurgitation although if high blood pressure should be treated if present.

Surgical options for Mitral Regurgitation:

When mitral regurgitation becomes severe, whether due to mitral valve prolapse or other causes, there is a significant risk of a weakening of the left ventricle which can lead to congestive heart failure. When a significant amount of the blood it is pumping is going backwards, the heart has to work much harder.  Patients with significant mitral regurgitation have a higher risk of developing arrhythmias like atrial fibrillation. Mitral regurgitation should be surgically corrected before the heart becomes damaged. Surgery may be necessary because of signs of deterioration that a cardiologist observes, usually on an echocardiogram, even if the patient displays no symptoms.

Valve surgery is recommended in patients with severe mitral regurgitation if they have any symptoms, atrial fibrillation, or pulmonary hypertension. Surgery is also recommended for patients without symptoms if their left ventricular is enlarged significantly or if pumping function is impaired.


Charles A. Shoultz, Jr., M.D., F.A.C.C.   •   Charles A. Shoultz, III, M.D., F.A.C.C.   •   Rodney A. Brown, M.D., F.A.C.C.
William R. Pitts, M.D., F.A.C.C.   •   Donald S. (Buck) Cross, M.D., F.A.C.C. • Andrew K. Day, M.D., F.A.C.C.
Sherwin F. Attai, M.D., F.A.C.C.   •   Shawn J. Skeen, M.D. F.A.C.C.   •   Harvey R. Chen, M.D. F.A.C.C.
Adam M. Falcone, M.D., F.A.C.C.   •   Brian C. Barnett, M.D., F.A.C.C.

Diplomates, American Board of Internal Medicine,
Cardiovascular Disease, Interventional Cardiology, Clinical Cardiac Electrophysiology