Mitral valve prolapse
Lawrence Kline, MD, is a board-certified cardiologist on staff at Banner Estrella Medical Center.
Question: I recently visited the Emergency Department with chest pains and palpitations and the doctor who saw me said he believed I had mitral-valve prolapse and that I should talk to my cardiologist right away. Did I have a heart attack? And why didn’t my primary care doctor find this condition sooner?
Answer: First, mitral-valve prolapse is not a disease or a heart attack. Mitral-valve prolapse is a condition that occurs when the valve between the top left chamber of your heart and the lower left chamber of your heart, the mitral valve, doesn’t open and close properly thus providing you with symptoms that can mimic a heart attack, such as shortness of breath, chest tightening, palpitations, or fatigue.
The mitral valve actually is made of two flaps of tissue that open and close to allow blood to flow in one direction—from the top left chamber down to the bottom left chamber. Mitral valve prolapse means the flaps have an abnormal billowing motion backward into the top left chamber. This can cause a clicking sound and a murmur, which is what the Emergency Department physician probably heard with his stethoscope when he made his diagnosis.
Mitral valve prolapse is a fairly common occurrence in women between 20 and 40 years old and remains present for the rest of their life unless it is corrected surgically. It is not commonly checked for during regular yearly physicals unless there is a history of such heart problems in the family or in your own personal history. This is why you were told to see a cardiologist.
Your cardiologist will consider your cardiovascular risk factors, including age, sex, family history and smoking history, as well as your symptoms and the results of diagnostic testing, such as blood tests. He may also encourage you to do an Exercise Stress Test to rule out coronary artery disease and an Echocardiogram (both non-invasive procedures) to get a good view of your heart and valves in motion.
The best thing to do would be to follow the emergency physician’s advice and see your cardiologist right away. Treatment for the symptoms of mitral valve prolapse can be as easy as reducing the amount of caffeine in your diet but may require taking a medication. More serious cases may require you to undergo surgery, which is why it is important to be proactive and talk with your cardiologist about your symptoms in a timely and honest manner.