Condition caused by bulging of mitral valve leaflets (thickened with myxamatous degeneration) into the left atrium during systole. Present in up to 5% of population. Usually asymptomatic and non-progressive. A small symptomatic sub-sect termed ‘MVP syndrome’ may present with chest pain and fatigue, palpitaions with dysrhythmias, severe mitral regurgitation, infective endocarditis, syncope, stroke and rarely sudden death. Typically, examination reveals a systolic ‘click’ and /or late systolic murmur that changes with body position confirmation by echocardiography.
Treatment
Asymptomatic majority without features of mitral regurgitation are advised to lead normal lives. Those with MVP murmur and in presence of thickened redundant leaflets on echo, need endocarditis prophylaxis. In those with palpitations, excess sympathetic tone and dizziness, B-blockers like Atenolol (25-50 mg/day) are helpful. These patient are also to be advised against participating in competitive sports. Valve repair might be needed in a small percentage of patients who have lived many years without any symptoms.
