mvp handouts

7/23/2019 MVP Handouts

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Mitral valve prolapse

Commonest MV lesion.

•

Billowing of 1 or 2 leaflets into LA beyond AV junction in systole.

•

With more severe prolapse MR occurs.

•

Most cases are mild, asymptomatic, benign.

•

Children with MVP rarely have MR or needsurgery.

MVP

• MVP may be congenital but is often

diagnosed in the teens. May be familial.

• May be caused by problems affecting part

of leaflet,1 or 2 leaflets, chordae tendinae, papillary muscle or valve ring.



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MVP

associated conditions

• Connective tissue disorders e.g. Marfan’s

• Inflammation – RF, IE.

• Myocardial ischaemia/infarct – affect

papillary muscle.

• Rupture of chordae in IE.

• IDIOPATHIC

• Associated with other CHD in children

MVP

• Prevalence 1-2% in children, 5-15% in

adolescents and young adults.

• In some studies F:M = 2:1.

• Associated with neuro endocrine imbalance

adrenaline/noradrenaline increased.

MVP

symptoms

• Most asymptomatic.

• Chest pain, palpitations, dyspnoea and

fatigue on exertion, anxiety attacks,

syncope.

• Associated skeletal abnormality – asthenic

build, increased arm span, arachnodactyly,

scoliosis, pectus excavatum.



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MVP

signs

• Mild cases of mitral valve prolapsesyndrome have only mid-systolic click.

• When MR occurs there is a late systolicmurmur.

• Murmur occurs earlier in systole on sittingup.

• If MR severe - signs of LA and LVenlargement +/- CCF.

MVP with MR

MVP

Investigations

• 2Decho parasternal long axis view shows prolapse of valve leaflets which may bethickened/redundant. Valve ring may be

enlarged.• MR may be demonstrated.

• ECG may show arrhythmias or non-specificST and T wave changes or chamberhypertrophy.



4

MVP

management

• For asymptomatic or with only anxiety –

reassure, follow clinically and repeat 2DE

every 3 years. The prognosis is good.

• Patients with MR should be reviewed at

least annually

• For severe MR – surgery, usually repair.

MVP

management

• Beta blockers for palpitations, syncope,

chest pains.

• Appropriate CCF treatment including

ACEI.

mvp handouts

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