Diagnosing And Treating Mitral Valve Prolapse
Mitral valve prolapse (MVP) is a form of valve insufficiency. One or both leaflets of the mitral valve (MV) flop back into the atrium, which allows blood to flow backward from the ventricle. This can cause a number of symptoms and complications. In the short run, dizziness, fatigue, and an inability to take deep breaths are common. In the long run, more serious side effects can develop.
You might experience an arrhythmia, such as atrial fibrillation. This can lead to clots in the left atrium, which might cause a stroke if they reach your brain. MVP may also lead to infection of the endocardium (known as endocarditis). Also, because prolapse allows blood to flow back into the atrium, you might experience increased pressure on your lungs and heart. This can eventually lead to heart failure.
MVP may be mild or serious. In most cases, treatment is unnecessary and symptoms may not be noticeable. Other times, surgery might be the best option for minimizing the condition's impact on your quality of life.
Diagnostic Tests Used
Doctors usually become aware of mitral valve prolapse through a stethoscope. They might hear a clicking sound that suggests the condition exists. However, the sound is merely an indicator. MVP must be confirmed by using one or more diagnostic tests.
X-rays will be taken of your chest to help your doctor make a diagnosis. But even x-rays may be inadequate if they are unable to provide a clear picture of the valve.
An echocardiogram is usually done to provide a clearer picture. This test uses ultrasound waves to create an image of your chest, heart, and valves.
Your doctor may also order an electrocardiogram (ECG). This test monitors the activity of your heart's electrical activity and can help identify abnormalities that suggest MVP.
If your physician is confident that MVP exists, he or she may have you perform a stress test. The purpose of this test is to gauge how well your heart performs with a leaking valve.
Cardiac catheterization is used when your doctor suspects MVP is severe enough to cause concern about your heart's function. A catheter is inserted in the groin and thread through a blood vessel to your heart. A contrast dye is released into your coronary arteries. The dye shows up on x-rays and provides your doctor with a clearer view of the arteries. It also exposes pressure in the atria and ventricles, which may suggest prolapse.
Types Of Medications Prescribed
Most patients do not require surgery. Their symptoms are either nonexistent or mild. In such cases, doctors often prescribe medications to help control symptoms and prevent complications.
Because mitral valve prolapse can cause blood to pool and clot in the left atrium, doctors often prescribe aspirin to prevent clotting. Anticoagulants may also be given, especially if MVP is accompanied by atrial fibrillation.
Your doctor might also prescribe beta-blockers to help regulate an abnormal heart rhythm. These drugs slow the rate of your heart and lower your blood pressure by inhibiting the effects of adrenaline in your body.
Mitral Valve Repair Surgery
If medications cannot control your symptoms, your doctor will recommend mitral valve repair surgery. A triangular resection can be performed to remove an abnormal portion of the posterior leaflet. An annulus is then placed around the MV to provide support. If the anterior leaflet is affected, the surgeon can perform a chordal transfer. This procedure is far more complex than a triangular resection. Supporting chords are transferred from the posterior leaflet to the anterior leaflet. In some cases, artificial Gor-Tex chords are used.
Mitral valve prolapse can be dangerous if the valve is severely diseased. Even if the condition seems benign, it can become serious down the road. Consult your doctor to discuss whether medications are sufficient or mitral valve repair surgery is more appropriate.
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