A mitral valve prolapse syndrome is a congenital malformation of the heart in the mitral valve apparatus. This leads to a bulging of the mitral valve parts.
What is Mitral Valve Prolapse Syndrome?
In the case of a mitral valve prolapse syndrome or mitral valve prolapse, the posterior mitral valve flap expands or balloons into the left atrium of the heart. However, both mitral valves can also be affected. Mitral valve prolapse is one of the most common heart valve changes in adults. The incident occurs more frequently in females than in males. See ablogtophone for KRS which stands for Cardiorenal Syndrome.
The first description of mitral valve prolapse syndrome was in 1963 by South African heart specialist John B. Barlow. Therefore, the disease is also known as Barlow’s disease or Barlow’s syndrome. Around five percent of all adults worldwide are affected by a mitral valve prolapse. In Germany, the rate is between one and two percent. Most cases of prolapse occur between the ages of 20 and 40.
In principle, however, a mitral valve prolapse syndrome can occur at any age. The mitral valve is located between the left ventricle and the left atrium of the heart. It supports the heart in pumping oxygen-enriched blood into the left ventricle via the left atrium. From there it gets further into the organism.
The mitral valve opens when blood flows in from the left atrium towards the left ventricle. When the ventricle contracts, the heart valve closes. The term mitral valve is due to the similarity of the flap with a miter, a bishop’s miter.
Causes
A mitral valve prolapse syndrome is caused by a connective tissue disorder. However, the reasons for this have not yet been clarified. It is assumed that genetic influences have an effect. In some people, it can occur due to hereditary connective tissue disorders, such as Marfan syndrome.
Such diseases result in overstretching, thickening, enlargement, or loosening of the mitral valve. Occasionally, however, a mitral valve prolapse also occurs following a heart attack. Damage to the papillary muscles is not uncommon. The tendons of the mitral valve originate from these.
Symptoms, Ailments & Signs
The symptoms that occur with a mitral valve prolapse syndrome are often very unspecific. It can be cardiac arrhythmia or symptoms similar to angina pectoris. Patients often also experience feelings of shortness of breath, restlessness, fear and tiredness. There is also stabbing pain in the chest. Severe symptomatic mitral regurgitation is rare. The same applies to an abrupt loss of consciousness. However, many affected people do not notice any symptoms at all.
Diagnosis & course of disease
If there are no symptoms, a mitral valve prolapse syndrome can usually only be discovered by the doctor by chance. To confirm the diagnosis, the heart is listened to (auscultation) and an echocardiography is performed. During auscultation, a systolic click can be heard, which is considered to be an expression of the systolic valve leaflet protrusion in the direction of the left atrium.
If the patient also suffers from mitral regurgitation, a systolic heart murmur can also be identified. When performing an echocardiography, the thickened valve leaflets are noticeable. The same applies to their systolic protrusion. If mitral regurgitation is suspected, it can be diagnosed by Doppler echocardiography. An EKG test usually produces normal results.
Sometimes it is also suitable for detecting possible cardiac arrhythmias. A long-term ECG, which the patient carries with them for 24 hours, is considered helpful for this purpose. In most cases, the course of a mitral valve prolapse syndrome is classified as positive. Only about three percent of all those affected have serious complications. These include cardiac insufficiency, arterial thromboembolism and severe cardiac arrhythmia, which in the worst case can lead to sudden cardiac death.
Complications
The mitral valve prolapse syndrome primarily causes problems with the heart. These complaints can have a very negative effect on the life expectancy of the patient and reduce it significantly. In most cases, this leads to inner restlessness and shortness of breath. Furthermore, those affected can also suffer from a fear of death and feel severe fatigue.
In most cases, it is no longer possible for the patient to carry out strenuous activities or sports due to the mitral valve prolapse syndrome. Exhaustion occurs and the patient’s resilience is reduced. The shortness of breath can also lead to a loss of consciousness, which can further lead to various complaints or injuries.
In the worst case, the patient dies of sudden cardiac death. If there are acute emergencies, treatment with medication is necessary. Complications usually do not arise. However, not all complaints can be completely eliminated, so that in some cases surgical interventions are necessary. In most cases, mitral valve prolapse syndrome is associated with a reduction in life expectancy.
When should you go to the doctor?
Since mitral valve prolapse syndrome is a congenital disorder, the first irregularities can appear shortly after birth. An intensive examination is necessary as soon as there are abnormalities in the heart rhythm. If you have an interrupted heartbeat, tachycardia or severe palpitations, you should see a doctor. Normally, newborns are examined in routine examinations immediately after delivery.
If the symptoms of the disease are already pronounced at this stage, they are automatically noticed by the treating pediatricians. Further tests are carried out to enable a diagnosis to be made. Parents should consult a doctor if no abnormalities were found in the initial examinations, but the symptoms appear in the first months or years of life.
If the growing child’s resilience is reduced in direct comparison with peers, the observations should be discussed with a doctor. If there are breathing disorders, restlessness or increased tiredness, a doctor is needed. In the event of acute shortness of breath, an emergency service must be alerted.
At the same time, first-aid measures must be taken by those present so that adequate medical care is guaranteed until the emergency doctor arrives. Reduced performance, lack of motivation, exhaustion and sluggishness are indications of a health impairment. A doctor’s visit is necessary as soon as the symptoms persist or increase.
Treatment & Therapy
If a mitral valve prolapse does not cause any symptoms, medical treatment can be dispensed with. If a mitral valve prolapse syndrome is present that causes symptoms, drug therapy for cardiac arrhythmia or angina pectoris symptoms is possible. Here, the patient receives either antiarrhythmic drugs or beta-blockers. If the mitral valve prolapse leads to valve insufficiency, complex medical therapy is required. There must be close medical control.
A malfunction of the mitral valve can be compensated for by the heart for a certain period of time, since it has an amplifying effect on its performance. However, if an overstrained tendon nerve is ruptured, there is a risk that the condition of the valve function will deteriorate further, resulting in acute shortness of breath. In such cases, emergency medical treatment is required. Furthermore, there is a change in the affected heart chamber, which can be attributed to increased loads.
As the chamber of the heart expands in volume, its musculature thickens at the same time. This threatens cardiac insufficiency that can no longer be corrected. In most cases, an operation of the mitral valve is then necessary. This is usually minimally invasive. Sometimes the mital valve is replaced entirely.
If there is a pronounced mitral valve prolapse syndrome, antibiotics should always be given as a preventive measure before minor surgical interventions or dental treatment. Even if there are no symptoms from a mitral valve prolapse, doctors recommend check-ups every three to five years. In the context of mital valve insufficiency, check-ups must be carried out every six to twelve months.
Outlook & Forecast
The prognosis for mitral valve prolapse syndrome is generally very good. In most cases, there are no symptoms at all, which is why patients can do without therapy. Only isolated check-ups are due. One performance every few years is sufficient. This does not affect the quality of life. Life expectancy remains at the previous level.
Statistically, three percent of all patients experience complications. These are often severe. One reason for the life-threatening situations is that an adverse change was recognized too late. A diagnosis in the late stage worsens the prospects significantly. The specific risks include endocarditis, cardiac arrhythmias and mitral valve insufficiency. As can be seen, deteriorations in health extend to the heart, explaining the existential dimension of mitral valve prolapse syndrome.
If a patient survives a complication, long-term limitations cannot be ruled out. So a long-term treatment can be indicated. Changes have to be accepted in everyday life. Contrary to what is sometimes assumed, mitral valve prolapse syndrome is not a phenomenon of old age. Most patients are between the ages of 20 and 40. Women are considered to be slightly more susceptible than men.
Prevention
There is no specific prevention of mitral valve prolapse syndrome. The triggering causes are still unknown.
Aftercare
Since the mitral valve prolapse syndrome is a congenital disease, the affected person usually has no special follow-up measures available. Therefore, the patient with this disease should ideally consult a doctor at an early stage, so that complications or other symptoms do not arise in the further course. If the patient or the parents wish to have children, genetic testing and counseling should be carried out to prevent the syndrome from recurring.
Most people affected by this disease are dependent on taking various medications that can alleviate and limit the symptoms. The person concerned should ensure that the medication is taken regularly and that the correct dosage is used in order to alleviate and limit the symptoms.
Regular checks of the internal organs are also very important, with the heart in particular being checked. In general, a healthy lifestyle can also have a positive effect on the course of mitral valve prolapse syndrome, and a balanced diet should also be observed. Further follow-up measures are usually not available to those affected by this disease. Life expectancy may be reduced by this disease.
You can do that yourself
Mitral valve prolapse syndrome carries very different risks depending on the manifestation. A weak mitral valve prolapse is often not discovered and causes no or only slight symptoms, so that no adjustment is made in everyday life. In those cases in which the functional anomaly of the mitral valve has been identified, but minimally invasive or surgical intervention is not (yet) recommended, an adaptation of everyday behavior and self-help measures can improve the general condition both subjectively and objectively.
Basically, physical and mental stress peaks should be avoided, because a sudden flooding of the body with stress hormones leads to an abrupt increase in blood pressure during the beating phase (systole) of the ventricles. This can increase the protrusion of one or both leaflets of the valve into the left atrium. On the other hand, it is quite helpful to give the heart incentives to strengthen it through light to moderate endurance sports.
Relaxation exercises such as autogenic training, breathing exercises, yoga and other techniques are well suited to deal with acute stressful situations in a way that is gentle on the heart. When it comes to sporting activities, endurance sports such as Nordic walking, swimming, cross-country skiing and golf are helpful in strengthening the heart without causing irreversible thickening of the heart walls. It is also important to pay attention to the subjective well-being when practicing the sport, without being fixated and concentrated on it.
