Mild mitral valve prolapse

There are many common problems with the mitral valve, and not only in adults but also in children. These problems can directly cause many problems in our heart, and the diseases caused by these problems are also quite widespread, including mild mitral valve prolapse. So what is mild mitral valve prolapse?

Mitral valve prolapse is the prolapse of the mitral valve leaflets (anterior, posterior, or both) into the left atrium (bulging toward the left atrium) during ventricular systole, with or without mitral regurgitation. The incidence rate in adults is about 5%. To the naked eye, the damaged valve appears transparent and jelly-like. The entire mitral valve is relaxed and may be raised to form a dome or arch shape.

This change can also be seen in a variety of connective tissue diseases, such as Marfan syndrome, osteogenesis imperfecta and coronary heart disease. Mitral valve prolapse most often affects the posterior leaflet. When the ventricle contracts, the overly long leaflets cause the valve to move further up into the left atrium. The sudden cessation of valve activity produces a click, and incomplete closure of the valve leaflets causes a regurgitant murmur in the mid- and late systole.

Onset is slow and the patient may be asymptomatic. Mitral valve prolapse is often detected during auscultation of the heart or when echocardiography is done for other reasons. Patients often complain of palpitations, fatigue, dyspnea, and chest pain, but symptoms are unrelated to activity, physical signs, and the degree of mitral regurgitation. A small number of patients often have palpitations.

The clinical diagnosis of mitral valve prolapse is mainly based on the typical auscultatory characteristics of mid-systolic click and mid- and late-systolic murmur, the effects of drugs and movements on the murmur, combined with echocardiography and left ventriculography when necessary, which can usually confirm the diagnosis. Primary mitral valve prolapse can only be considered after mitral valve prolapse secondary to various cardiovascular diseases or systemic diseases has been excluded.

treat

1. Medication

(1) Prevent infective endocarditis.

(2) β-blockers are effective for palpitations, chest pain, fatigue, and anxiety.

2. Surgery

(1) Indications: ① Symptomatic severe mitral regurgitation and/or left ventricular systolic dysfunction. ②LVEDD>70mm, LVEDVI>200ml/m, EF<50%, regardless of whether there are symptoms or not. ③ Malignant heart rhythm disorders or severe chest pain that cannot be controlled by drugs.

(2) Orthotoplasty

The surgery should be performed by direct vision angioplasty if possible, otherwise mitral valve replacement should be performed.