Mitral Valve Prolapse Research Paper

Mitral Valve Prolapse Nichole Scalone April 16, 2013 Cvt 212 Professor Amelia Pose

The human heart is the strongest and most vital organ in the human body.
This amazing machine keeps us alive day after day and it is important to take care of our bodies so we can live a long healthy life. Although sometimes no matter how much we take care of ourselves through proper nutrition and daily exercise problems can occur which we are not at fault. Mitral valve prolapse is one of these conditions that the cause is still unknown. Researchers think it may be hereditary and people can be born
with it but never experience any symptoms. Although mitral valve prolapse is not usually life threatening some people may require treatment and a complete change of lifestyle. Mitral valve prolapse, or MVP, is defined as a valvular heart disorder in which one or both mitral valve flaps close incompletely during systole usually producing either a click or murmur and sometimes produces minor mitral regurgitation. The mitral valve is one of the four heart valves. A normal mitral valve consists of two thin leaflets, located between the left atrium and the left ventricle of the heart. Mitral valve leaflets, shaped like parachutes, are attached to the inner wall of the left ventricle by a series of strings called "chordae." When the ventricles contract, the mitral valve leaflets close tightly and prevent the backflow of blood from the left ventricle into the left atrium. When the ventricles relax, the valves open to allow oxygenated blood from the lungs to fill the left ventricle. In patients with mitral valve prolapse the valve leaflets and Chordae becomes affected by a process called myxomatous degeneration. In myxomatous degeneration, the structural protein collagen forms abnormally and causes thickening, enlargement, and redundancy of the leaflets and chordae. Blood normally flows through the mitral valve from the left atrium to the left ventricle of the heart. When the ventricles contract, the leaflets prolapse (flop backwards) into the left atrium, sometimes allowing leakage of blood through the valve opening back into the left atrium. This is known a mitral regurgitation. When severe, mitral regurgitation can lead to heart failure and abnormal heart rhythms.

When people start to feel symptoms of mitral valve prolapse they usually get heart palpitations, fatigue, chest pain, anxiety, and migraine headaches. Fatigue is the most common complaint. Patients with mitral valve prolapse may have imbalances in their autonomic nervous system, which regulates heart rate and breathing. Such imbalances may cause inadequate blood oxygen delivery to the working muscles during exercise, thereby causing fatigue. Palpitations are sensations of fast or irregular heartbeats. Most people say they feel as if their heart is doing flips inside their chest. In most patients with mitral valve prolapse palpitations are harmless but in very rare cases serious heart rhythm abnormalities may underlie palpitations and more testing should be done. Chest pain, anxiety, panic attacks, and depression may be associated with mitral valve prolapse but many researchers believe these symptoms to be related to imbalances of the autonomic nervous system. Many people who don’t have symptoms find out they have mitral valve prolapse during a general physical exam.
When a doctor is examining a patient with a stethoscope, a clicking sound is heard soon after the ventricle begins to contract. This clicking is felt to reflect tightening of the abnormal valve leaflets against the pressure load of the left ventricle. If there is associated leakage of blood through the abnormal valve opening a "whooshing" sound can be heard immediately following the clicking sound. This is a heart murmur. After a doctor believes to have detected mitral valve prolapse the patient is sent for an echocardiograph. An echocardiograph is the most useful test for mitral valve prolapse. Echocardiography can measure the severity of prolapse and the degree of mitral regurgitation. It can also detect areas of infection on the abnormal valves. Valve infection is called endocarditis and is a very rare, but potentially serious complication of mitral valve prolapse. Echocardiography can also evaluate the effect of prolapse and regurgitation on the functioning of the muscles of the ventricles. When a patient is suffering from abnormally rapid or irregular heartbeats they are usually given a 24-hour Holter monitor. This is a device that takes a continuous recording of the patient 's heart rhythm as the patient carries on daily activities. When abnormal rhythms occur during the test period they are captured and analyzed at a later date. If abnormal rhythms do not occur every day, the Holter recording may fail to capture the abnormal rhythms. These patients then can be fitted with a small event recorder to be worn for up to several weeks. When the patient senses a palpitation, an event button can be pressed to record the heart rhythm prior to, during, and after the palpitations. These machines help the doctors to diagnosis the severity of the patient’s heart
abnormality. The vast majority of patients with mitral valve prolapse have an excellent prognosis and need no treatment. Most patients get routine examinations including echocardiograms every few years. Patients with Mitral regurgitation with mitral valve prolapse need to be evaluated annually because this can lead to heart failure, heart enlargement, and abnormal rhythms. Patients with severe prolapse, abnormal heart rhythms, fainting spells, significant palpitations, chest pain, and anxiety attacks may need treatment. Beta-blockers are usually given to increasing the size of the left ventricle, thereby reducing the degree of prolapse. Calcium blockers are given to patients who cannot tolerate beta-blockers. And in the very rare and most severe cases surgery may be required. Patients who require surgery usually have severe mitral regurgitation causing worsening heart failure and progressive heart enlargement. The majority of patients with symptoms of mitral valve prolapse have bothersome but not life-threatening problems and only a very small minority of patients goes on to need surgery or other aggressive therapies. Also, the symptoms can come and go, then disappear for some time. They may be aggravated by stress, pregnancy, fatigue, other illnesses or menstrual cycles. Proper hygiene, a healthy balanced diet, exercise and yearly physical exams are very important for a healthy heart. Again, although patients with mitral valve prolapse may experience a variety of complications, most have no symptoms and can lead healthy, active, and normal lives.

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Mitral valve prolapse: causes, clinical manifestations, and management. Authors: Devereux RB, Kramer-Fox R, Kligfield P. Ann Intern Med. 1989 Aug 15;111(4):305-17. http://www.ncbi.nlm.nih.gov/pubmed/2667419
Current management of mitral valve prolapse. Authors: Bouknight DP, O 'Rourke RA. http://www.ncbi.nlm.nih.gov/pubmed/10865929 Am Fam Physician. 2000 Jun 1;61(11):3343-50, 3353-4. http://www.riversideonline.com/source/images/

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