Mitral Valve Prolapse (Barlow Syndrome)

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WHAT IS MITRAL VALVE PROLAPSE? Mitral valve prolapse syndrome is also known as the “Barlow’s Syndrome“, “Floppy-valve Syndrome“, “Click-murmur Syndrome“, “Billowing Mitral Valve Syndrome” or “Myxomatous Mitral Valve Disease“.  Barlow’s syndrome is a condition that occurs in patients with Marfan’s Syndrome, rheumatic heart disease, or Graves’ disease and it is caused by irregular closure of […] Read More

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Mitral Valve Prolapse (Barlow Syndrome)

WHAT IS MITRAL VALVE PROLAPSE? Mitral valve prolapse syndrome is also known as the “Barlow’s Syndrome“, “Floppy-valve Syndrome“, “Click-murmur Syndrome“, “Billowing Mitral Valve Syndrome” or “Myxomatous Mitral Valve Disease“.  Barlow’s syndrome is a condition that occurs in patients with Marfan’s Syndrome, rheumatic heart disease, or Graves’ disease and it is caused by irregular closure of the mitral valve which is located between the left ventricle and left atrium of the heart. This is frequent when the leaflets or flaps of the heart’s prolapse like a parachute into the upper chamber in the left part of the heart as the heart contracts. As a result, blood leaks backward into the left atrium termed “Mitral Valve Regurgitation“. The heart possesses two flaps which are bounded during the contraction by the small tendon cords that connect the heart muscles to the flaps known as the chordae tendineae. The valves permit the flow of blood in the forward direction which makes it detrimental when there is a backflow of blood. These flaps tend to stretch and enlarge inward which sometimes leads to regurgitation.  Statistics reveal that in India, little more than 10 million people have mitral valve syndrome every year, though, only a few of those cases are life-threatening where certain medications and surgeries are performed. In most cases, treatments are not necessarily required.
  1. Dilated cardiomyopathy
  2. Myocardial ischemia
  3. Hypertrophic cardiomyopathy
MITRAL VALVE PROLAPSE RISK FACTORS Mitral valve prolapse can occur in any individual at any age. Though, severe symptoms of mitral valve prolapse are prevalent in men above the age of 50 years.  Mitral valve prolapse can develop in families due to its affiliations with the gene and may be linked to several other conditions, such as:
  1. Ebstein anomaly
  2. Graves’ disease
  3. Ehlers-Danlos syndrome
  4. Marfan syndrome
  5. Scoliosis
  6. Muscular dystrophy
MITRAL VALVE PROLAPSE COMPLICATIONS Though in most people, the mitral valve prolapse never brings issue some complications can occur. They may include:
  • Mitral Valve Regurgitation
This is the most common complication as regurgitation is a condition in which the blood leaks through the valve back into the left atrium.  For this condition, the male gender is more susceptible, then, people with high blood pressure are at high risks of experiencing mitral valve regurgitation. Also, when regurgitation is severe, surgery may be required to replace or repair the valve to prevent sudden heart failure.
  • Arrhythmias
This condition involves problems with the heartbeat. This irregular heartbeat tends to occur in the upper chambers of the heart, though, they are not life-threatening. Arrhythmias are acquainted with people with severe mitral valve regurgitation or deformity and this is responsible for the irregular heartbeats due to the flow of blood through the heart.
  • Endocarditis
This involves the infection of the heart valve. The internal part of the heart is lined by a thin membrane known as the endocardium.  Endocarditis is an infection of this inner lining. Irregular mitral valve functionality spikes the rate of having endocarditis due to the presence of bacteria that can further damage the valve. MITRAL VALVE PROLAPSE DIAGNOSIS For diagnosing mitral valve prolapse, the doctor starts by checking for the heart sounds to rule out any possible clicking sounds that may indicate the presence of the mitral valve prolapse. It also permits the doctor to deduct the presence of mitral valve regurgitation. Other tests to diagnose Barlow’s syndrome may include:
  1. Echocardiogram
  2. Electrocardiogram (ECG)
  3. Chest X-ray
  4. Coronary Angiogram
  5. Stress Test
MITRAL VALVE PROLAPSE TREATMENT In some cases where the prolapse is not severe when the patient has developed mitral valve regurgitation, the doctor may prescribe medications but if the patient’s condition does not respond to these medications administered, the physician may recommend surgery.
  • Medications 
Medications are administered by the doctor when there is any development of symptoms or the patient has been diagnosed with mitral valve regurgitation.  Some common mitral valve prolapse medications administered include aspirin, beta-blockers, blood thinners, diuretics, and anti-arrhythmic medications.
  • Surgery
Mitral valve prolapse surgery is the preferred option for treatment when the patient has mitral valve regurgitations, whether the symptoms are present or not. The various methods used in surgery are repair or replacement of valves.
  • Valve Repair
This is a common approach used in most cases of mitral valve regurgitations. The mitral valve is repaired by connecting the leaflets of the valve or by the extermination of the excess tissues to facilitate the tight closing of the leaflets. Sometimes the mitral valve is also repaired by replacing the annulus.
  • Valve Replacement
Valve replacement is not often performed as it is mainly used as an alternative in few cases when repairing the mitral valve is not a feasible option. It involves the replacement of the damaged mitral valve by a prosthetic or artificial valve.  Artificial valves consist of two types which are tissue valves and mechanical valves (made from animal tissues). Mechanical valves tend to last longer, and the individual has to take anti-coagulant medications throughout their lifespan.  Tissue valves can wear out easily making it disadvantageous. Though, patients who choose the tissue valve, do not have to take anticoagulant medication. MITRAL VALVE PROLAPSE MORTALITY RATE Mitral valve prolapse mortality is placed at 217 deaths per 100,000 persons per year.

Symptoms

MITRAL VALVE PROLAPSE SYMPTOMS

Most times, symptoms are rare for patients with Barlow’s syndrome. However, some people may experience symptoms which may include:

  1. Irregular heartbeat (arrhythmia)
  2. Fatigue
  3. Chest pain
  4. Migraine (one-sided headache, accompanied with nausea)
  5. Low blood pressure in lying position (orthostatic hypotension)
  6. Panic attacks
  7. Anxiety
  8. Dyspnea (shortness of breath)
  9. Dizziness and lightheadedness

Causes

MITRAL VALVE PROLAPSE CAUSES

The mitral valve regulates the flow of blood between the upper chamber and lower chambers of the left part of the heart. Hence, when the heart is functioning properly, the mitral valve closes fully and the heart pumps blood and prevents the back-flow of blood into the left atrium of the upper left chamber.

The major cause of the prolapses in the valve can be attributed to the degeneration of valvular tissues which leads to the presence of extra tissue or overstretch in one or both of the mitral valve flaps causing them to bulge into the atrium each time the contractions in the heart occur. This prevents the valve from tightening properly when contracting to lead to the back-flow of blood.

Another common cause of the MVP is an abnormal stretch in the valve leaflets regarded as myxomatous valve disease. Mitral valve prolapse tends to occur in about 2% of the population as a person can be born with the risk of developing mitral valve prolapse due to the genetic structure of the person. It also can be a result of other health conditions, such as some connective tissue diseases.

In some people, the back-flow of the blood or leakage may be little which makes it a minor issue. But when the blood leakage is severe, it can be life-threatening. 

The causes of mitral valve prolapse can also include:

FAQ

Is mitral valve prolapse fatal?

Mitral valve prolapse is not a life-threatening condition, hence, it is not fatal and it does not require any form of lifestyle change.

Can mitral valve prolapse cause sudden death?

Mitral valve prolapse may not necessarily result in sudden death but the rate of occurrence is considerably low.

How do you know if your mitral valve prolapse is getting worse?

For some patients, the condition increases with time, but generally, it varies from patient to patient.

Can you have a heart attack from mitral valve prolapse?

When the condition is severe to result in mitral valve regurgitation, complications like stroke and heart attack tend to occur.

What should I avoid if I have mitral valve prolapse?

Sugar, alcohol, and sodium consumption should be limited and regular exercises are recommended.