Mitral valve prolapse syndrome

INTRODUCTION

Mitral valve prolapse (MVP) is associated with a wide variety of clinical features. There are potentially serious arrhythmic and nonarrhythmic complications such as sudden death and infective endocarditis. (See "Arrhythmic complications of mitral valve prolapse" and "Nonarrhythmic complications of mitral valve prolapse".)

In addition, a variety of more nonspecific complaints have been associated with MVP. Atypical or non-anginal chest pain is the most common symptom attributed to MVP. Other manifestations may include:

• Palpitations
• Dyspnea
• Exercise intolerance
• Dizziness or syncope
• Panic and anxiety disorders
• Numbness or tingling
• Skeletal abnormalities
• Abnormal resting and exercise electrocardiograms

Any combination of these symptoms and signs plus the typical auscultatory features of MVP have been defined as the mitral valve prolapse syndrome. This topic will review the validity, pathophysiology, and treatment of this disorder.

VALIDITY OF THE SYNDROME

The large number of symptoms directly attributed to MVP may be coincidental. The questionable link between MVP and the above list of nonspecific symptoms may have originated because of inaccurate study designs and selection bias. As an example, many studies may not have had well matched control groups, which is essential because many of the symptoms attributed to MVP commonly occur in the general population. In addition, studies based at tertiary care centers may have attracted potentially more symptomatic patients than those who seek medical attention at smaller medical centers. Thus, trials performed at these centers may have overestimated the true prevalence of symptomatic patients with MVP.