Mitral valve prolapse (MVP) is a relatively common heart valve condition that affects between 2–3% of the population. It occurs when the leaflets of the mitral valve (the valve between the left atrium and left ventricle) become floppy or thickened and bulge (prolapse) back into the left atrium during the heart’s contraction.
While many cases of MVP are mild and harmless, in some people it can cause mitral regurgitation (backward leakage of blood), leading to symptoms such as palpitations, chest pain, shortness of breath, or in rare cases, complications such as arrhythmias, endocarditis, or heart failure.
Mitral valve prolapse is sometimes referred to as “click-murmur syndrome” because of the characteristic clicking sound and heart murmur doctors can hear during examination. It is often diagnosed incidentally during a routine check-up or echocardiogram.
Many people with MVP have no symptoms at all and live normal lives. However, some patients develop noticeable symptoms, particularly if mitral regurgitation is present.
Palpitations – awareness of fast or irregular heartbeat
Chest pain or discomfort (not always related to exertion, can be sharp or stabbing)
Shortness of breath, especially during exertion or when lying flat
Fatigue, reduced exercise tolerance
Dizziness or lightheadedness
Anxiety and panic attacks (sometimes associated with MVP syndrome)
Fainting (syncope) due to arrhythmias.
Stroke or transient ischaemic attack (TIA) due to clot formation in the heart.
Sudden worsening of symptoms if severe mitral regurgitation develops.
You should seek medical attention if you experience:
Frequent palpitations or irregular heartbeat
Chest pain lasting more than a few minutes
Unexplained fainting spells
Shortness of breath or exercise intolerance
Swelling in ankles or feet (suggestive of heart failure)
Family history of sudden cardiac death or severe valve disease
MVP is diagnosed using a combination of history, physical exam, and imaging.
Doctor listens for the click-murmur during auscultation.
Family history of MVP or connective tissue disorders (e.g., Marfan syndrome) may be relevant.
Transthoracic echocardiography (TTE): Gold standard test for diagnosis.
Identifies prolapse of mitral valve leaflets and assesses degree of regurgitation.
Transoesophageal echo (TOE): Provides more detailed images, useful before surgery.
May show arrhythmias such as atrial fibrillation or premature ventricular contractions.
24-48 hour ECG monitoring to detect intermittent arrhythmias.
Evaluates impact of MVP on exercise tolerance and rhythm stability.
Provides additional structural details in complex cases.
Treatment depends on symptoms and severity of valve dysfunction.
Most patients with mild MVP and no significant regurgitation require only monitoring.
Regular echocardiograms to check progression.
Beta-blockers: Reduce palpitations, chest discomfort, and arrhythmias.
Anti-arrhythmic drugs: For significant rhythm disturbances.
Anticoagulants (blood thinners): If atrial fibrillation or history of stroke is present.
Diuretics or heart failure medications: If severe regurgitation leads to fluid retention.
Mitral valve repair: Preferred over replacement; involves reshaping or reinforcing the valve to prevent prolapse.
Mitral valve replacement: Used when repair is not feasible.
Transcatheter edge-to-edge repair (MitraClip): Option for high-risk surgical patients with severe regurgitation.
Most patients live normal, active lives with MVP.
Lifestyle tips:
Heart-healthy diet, low in saturated fats and salt
Regular exercise (avoid extreme exertion if severe regurgitation present)
Avoid excessive caffeine and stimulants if palpitations occur
Quit smoking and limit alcohol
Good dental hygiene is important to reduce risk of infective endocarditis.
Regular follow-ups with a cardiologist are essential.
Patients with connective tissue disorders (e.g., Marfan, Ehlers-Danlos) require closer monitoring.
Most people with MVP have an excellent prognosis.
Severe complications occur in only a minority of patients.
Risk increases if severe mitral regurgitation, atrial fibrillation, or left ventricular dysfunction develops.
With timely surgical or interventional treatment, long-term outcomes are very good.
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