Mitral valve prolapse (MVP) is a heart condition involving the valve that allows blood from the left atrium to the left ventricle. The flaps that close the valve become prolapsed, bulging in such a way as to allow the potential for blood to leak back into the atrium. While MVP is rarely problematic, it can cause symptoms that require managing. Here’s a look at treatments for mitral valve prolapse when it does cause issues.
Medications
The biggest concern of mitral valve prolapse is that the backflow of blood will cause a condition called mitral valve regurgitation. When blood does flow back into the atrium, symptomatic treatment may be necessary. This can eventually strain the heart muscles, leading to an arrhythmia. An arrhythmia is a sort of erratic heartbeat; the heart may beat too hard, too fast, or seem to skip a beat or other abnormalities. Beta-blockers are often used to treat this; this type of medication lowers blood pressure, allowing the heart to beat slower and gentler, as well as improving blood flow by expanding blood vessels.
A variety of other medications, such as sotalol or flecainide, can be used to manage the rhythm of the heart beat. Vasodilators help enlarge the blood vessels, easing blood flow and making it easier for the heart to beat. Atrial fibrillation is a specific sort of arrhythmia in which the heart flutters rather than beating firmly and is one of the more dangerous types. Combined with mitral valve issues or a history of strokes, your doctor may recommended an anticoagulant or a low dose of aspirin to prevent clotting and help blood flow.
Digoxin is another medication that is intended to make the heartbeat stronger. Additionally, MVP, mitral valve regurgitation, and other heart conditions can cause fluid retention, particularly in the lungs, which can result in breathing difficulties and coughing. A diuretic can help encourage the body to get rid of this extra fluid. A combination of these medications may be necessary and may help additional symptoms, such as dizziness, brought on by active MVP symptoms through improved blood flow and easier heart beats.
Surgical Treatments
Over time, as the heart muscle becomes more and more strained, this can cause symptoms to grow worse. Eventually, surgical interventions may be necessary. This is generally reserved for extreme abnormalities, in which heart failure becomes a serious concern. Essentially, you and your cardiologist must decide if your mitral valve prolapse is severe enough to expose you to the risk of heart surgery, without waiting until your heart is too weak to withstand surgery.
Traditionally, mitral valve repairs and replacements are open heart surgeries, requiring cutting open the chest to completely expose the heart. However, new methods are slowly gaining popularity; one involves multiple smaller cuts along the chest wall, while the other involves using a catheter threaded through a large vein until it reaches the heart. This is called transcatheter valve therapy, and is used for people who are not good candidates for open heart surgery (generally because of severe mitral valve regurgitation. These allow for less blood loss, less exposure to infection, and faster healing times.
In any case, if the mitral valve isn’t too damaged, it may be possible to repair the valve in a procedure called a “valvuloplasty.” Conversely, the opening the valve covers may need to be repaired (annuloplasty). If the valve is beyond repair, your mitral valve may be replaced with an artificial or prosthetic valve, a valve taken from a cow or pig, or a valve made from human tissue. Man-made valve replacements require a lifetime of blood thinners; biological valve replacements do not require blood thinners, but only last for about a decade. Talk to your doctor about the best option for you.
