Treatment of MVP

"Most people who have mitral valve prolapse (MVP) don’t need treatment because they don’t have symptoms and complications" (nih.gov, 2016).

"Even people who do have symptoms may not need treatment. The presence of symptoms doesn’t always mean that the backflow of blood through the valve is significant" (nih.gov,2016).

In the event that MVP has regurgitation the condition is treated with either medications or surgery.

Medications:

Beta blockers- prescribed to treat palpitations and chest discomfort in people with little to no backflow.

Significant backflow and symptoms results in prescriptions of:

Blood thinners- to prevent clots from forming.
Digoxin- to strengthen heart beat.
Diuretics- to remove excess fluid and sodium from the body and lungs.
Flecainide and Procainamide- to regulate heart rhythms.
Vasodilators- to reduce workload on the heart.

(nih.gov, 2016)


Surgery:

Traditionally, surgeons repair or replace the mitral valve.

Repair is more favorable considering it has less risk of infection and has more strength and success in the long run.

Replacements are with pig or cow heart valves, but the downside is that the valves weaken over a ten year period approximately.

(nih.gov, 2016)



(health.sjm.com, 2016)

References

https://www.nhlbi.nih.gov/health/health-topics/topics/mvp/treatment

https://health.sjm.com/heart-valve-answers/treatment-options/heart-valve-replacement

MVP Signs and Symptoms

Most people with MVP have no symptoms at all, but in the small population that endures symptoms chest pain in the most frequently reported (Webmd.com)

(www.pinterest.com)

Mitral regurgitation also is mostly commonly from MVP and can, over years and decades, lead to congestive heart failure which presents with swelling of the legs and shortness of breath with exertion (Webmd.com).



(www.heart-valve-surgery.com)


Lesser symptoms linked to MVP include:

• Heart palpiations
• Dizziness
• Syncope
• Anxiety and panic
• Numbness and tingling of the hands and feet

(Webmd.com)

References

http://www.webmd.com/heart/mitral-valve-prolapse-symptoms-causes-and-treatment#2

How to Diagnosis MVP!

The echocardiogram is the gold standard diagnostic tool for determining if a person has mitral valve prolapse (MVP). In a Framington heart study it was determined by Freed et al that the echocardiogram criteria for MVP included classic and non-classic MVP.

Classic MVP: The parasternal long axis view show > 2mm superior displacement of the mitral leaflets into the left atrium during systole, with a leaflet thickness of at least 5mm.

Non-classic MVP: Displacement is > 2mm, with a maximal leaflet thickness of < 5mm.

(medscape.com)


(myheart.net)

(myheart.net)


(clevelandclinicmeded.com)


(ehjcimaging.org)

References

http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/mitral-valve-disease/

http://ehjcimaging.oxfordjournals.org/content/11/4/307

http://emedicine.medscape.com/article/155494-workup#showall

Freed LA, Benjamin EJ, Levy D, et al. Mitral valve prolapse in the general population: the benign                     nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol.                     2002 Oct 2. 40(7):1298-304.

http://myheart.net/articles/mitral-valve-prolapse-part-5-from-fiasco-to-sensibility-how-common-is-it/

How this thing works...Etiology/pathophysiology of MVP.

The mitral valve is made up of three distinct layers: Atrial side, the spongiosa, and the fibrosa of the ventricular side.



(Delling and Vasan, 2014)





Prolapse of the intermediate posterior mitral valve scallop (P2) shown in a long-axis view of (A) a 2-dimensional (2D) transthoracic echocardiogram, (B) a 2D transesophageal echocardiogram (TEE) with (C) associated severe, eccentric, anteriorly directed mitral regurgitation, and (D) a 3-dimensional TEE surgical view. AO indicates aorta; LA, left atrium; LV, left ventricle; and RV, right ventricle.
(Delling and Vasan, 2014)


The reason for mitral valve prolapse arises from either of two degenerative processes of main histological phenotypes: diffuse myxomatous disease (Barlow's disease) or fibroelastic deficiency.

Barlow's disease is characterized by thickened and diffusely redundant myxomatous leaflet tissue with disrupted collagen and elastic layers, leading to prolapse.

Fibroelastic deficiency is characterized by decreased connective tissue deficient in collagen, elastin, and proteglycans. This may lead to chordal rupture and flail leaflets, thus causing prolapse to occur.
 (Delling and Vasan, 2014)


References

Delling, F. N., & Vasan, R. S. (2014). Epidemiology and Pathophysiology of Mitral Valve Prolapse: New Insights Into Disease Progression, Genetics, and Molecular Basis. Circulation, 129(21), 2158-2170.

The mechanics of MVP : Etiology/pathophysiology of MVP

How does it come about???????

An article Delling and Vasan well explains mitral valve prolapse (MVP) and just where it comes from. They state to diagnose the condition it requires a, "physical examination and a 2-dimensional echocardiogram.

The picture provided by the echocardiogram shows the healthcare team the mitral valve of the heart and if the leaflets are ballooning back into the atrium. A non-statistically significant link believes that MVP is more prone in females than in males. According to the Medscape website MVP is the most common valvular abnormality, affecting 2-6% of the population  of the United States. 

Additionally, the Women's Heart Foundation reports that MVP is the most common of the heart valve conditions and that it affect 6% of all women.

References

1. Delling FN, 
2. Vasan RS

. Epidemiology and pathophysiology of mitral valve prolapse: new insights into                                          disease progression, genetics, and molecular                                                                                             basis. Circulation.2014;129(21):2158–2170pmid:24867995

http://emedicine.medscape.com/article/155494-overview

http://www.womensheart.org/content/heartdisease/mitral_valve_prolapse.asp