I have had many patients come to me with a diagnosis of Mitral Valve Prolapse (MVP), who do not actually have the diagnosis. This unfortunately is not good for both the patients and the health care system because it leads to wasted health care dollars on unnecessary tests and treatments/antibiotic prophylaxis and also will make the patients worry for no reason at all. Furthermore, who knows if this will affect future health insurance premiums.
The mitral valve, which is the valve on the left side of the heart that separates the left atrium (the top chamber of the left side of the heart, which is the collecting chamber of blood coming from the lungs) to the left ventricle (the bottom part of the heart which is the chamber that receives blood from the left atrium when the mitral valve is open, this blood eventually is pumped to the rest of the body). The prolapsing of the mitral valve is when one side or both sides of the mitral valve fall back too far into the left chamber while the mitral valve is closed during sytole. Over time, this may lead to a leaky valve, but in the short term, it may provoke symptoms of palpitations, fatigue, lightheadedness, shortness of breath, loss of consciousness and even chest pain. Sometimes, these symptoms arise during a bowel movement.
On exam of the patient, one may hear a click or murmur, but at times there may no signs of the disorder. It has been called the clickmurmur syndrome. Many people have MVP, it has been estimated that between 2-4% of the US population has MVP. It has been associated with syndromes such as: scoliosis, straight back syndrome, and other congenital abnormalities. It is more common in women than men.
The only way to truly diagnose MVP is by echocardiogram, which is the ultrasound of the heart, which will show the prolapse of the mitral valve. This is perhaps why the diagnosis is overdiagnosed; because many doctors may just hear a click and assume it is related to MVP.
The only serious risk with MVP is that over a long time, some patients may develop a severe leakage in the mitral valve that may lead to heart failure and even an irregular heart beat such as atrial fibrillation, in some patients this could also lead to sudden cardiac death, although rarely. The treatment for a leaky valve may be to repair or even replace the mitral valve, both which usually require open heart surgery, although never less invasive techniques are emerging.
Although it is controversial, many physicians and dentist still give antibiotics to patients with MVP who are coming in for dental work. In many instances, they do not need the antibiotics and in other instances, they may not even have a true diagnosis of MVP.