Heart Valve Issues: Risks, Prevention, and Monitoring - Cardiology

Dr. He Dongjin reply Cardiology

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Hello, relax! This is mitral valve prolapse, and of course, it won't lead to death.
There are no diseases that would cause you to die without treatment; you only need to see a doctor every 3-5 years, as it rarely worsens.
Doctors always leave a caveat, suggesting you don't need to return for follow-ups, which is strange.
In any case, it's not a big deal, so don't worry.
Here’s an article introducing mitral valve prolapse for your reference.
Mitral valve prolapse is the most common condition.
It is a syndrome that can be caused by abnormalities in one or more structures of the mitral valve, including the leaflets, chordae tendineae, papillary muscles, or the valve annulus, and may be associated with mitral regurgitation (backflow).

What causes mitral valve prolapse? Some cases have a genetic predisposition, with a prevalence in females that is twice that of males.
It is more commonly found in first-degree relatives of those with mitral valve prolapse, individuals with a slender build, and those with congenital conditions such as scoliosis, pectus excavatum, or pectus carinatum.
Due to changes in the connective tissue of the mitral valve, there is abnormal hyperplasia of the middle layer of the spongy structure, causing the mitral valve to appear thickened and elongated, leading to the prolapse phenomenon during closure, hence the term mitral valve prolapse.
How is the diagnosis of mitral valve prolapse confirmed? Clinically, it often presents with non-specific symptoms such as palpitations, chest discomfort, and easy fatigue, and there is often a tendency towards anxiety and tension.
The physician's stethoscope is the first diagnostic tool, allowing the detection of typical mid-systolic click sounds and possible accompanying systolic murmurs.
The definitive diagnostic tool is echocardiography.
Simple mitral valve prolapse must meet the international diagnostic criteria of a displacement of more than 2 mm above the mitral valve annulus line.
Other changes, such as valve thickening, can also be used to confirm the diagnosis of mitral valve prolapse.

Overdiagnosis should be avoided to prevent unnecessary psychological burdens and wasteful medical expenses.

Does mitral valve prolapse require surgery? Some changes in the connective tissue of the mitral valve may extend to the chordae tendineae and valve annulus, leading to chordal rupture and annular dilation or calcification, resulting in moderate to severe mitral regurgitation.
Fortunately, these cases account for only about 10% of all mitral valve prolapse cases.
The management principles and surgical indications for severe mitral valve prolapse with regurgitation are similar to those for severe regurgitation caused by other reasons.
What are the potential complications of mitral valve prolapse? A small number may experience thrombotic events due to damage to the endothelial layer of the valve surface, leading to conditions such as stroke or retinal artery occlusion; a few may also develop arrhythmias.
Patients with mitral valve prolapse accompanied by regurgitation and heart murmurs have a higher risk of developing infective endocarditis.
Sudden cardiac death is associated with severe mitral regurgitation, significant structural abnormalities of the valve, or the presence of ventricular arrhythmias.
Pharmacological treatment for mitral valve prolapse includes beta-blockers or the use of anxiolytics, which can improve most symptoms, but the structure of the valve will not change with medication.
If the patient has arrhythmias or cardiac enlargement due to regurgitation, additional antiarrhythmic medications or cardiac drugs may be necessary.
How often should mitral valve prolapse be monitored? If the mitral valve functions normally and the patient has no specific symptoms, due to the good prognosis, it is advisable to maintain a normal lifestyle and undergo echocardiography every 3 to 5 years.
If there are significant systolic murmurs and mitral regurgitation, prophylactic antibiotics for endocarditis become necessary; this group of patients must be monitored more frequently, approximately once a year with echocardiography.
In summary, we have gained a deeper understanding of mitral valve prolapse.
Remember, most cases of mitral valve prolapse are benign, usually with a good prognosis, requiring only observation and echocardiographic follow-up every few years.
If you have any questions, feel free to discuss them with a physician at our cardiology clinic.
Don't let mitral valve prolapse become a psychological burden; you can still enjoy a healthy and active life like anyone else.

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Reply Date: 2012/07/02