Mitral valve prolapse


  • 1 or more mitral valve leaflets bow into left atrium during systole
  • Most common valve disease in industrial countries (2.4% of pop.)
  • Myxomatous degeneration from connective tissue disorder

Clinical Features


  • Studies failed to demonstrate that chest pain, anxiety, or palpitations are associated with MVP
  • Symptoms related to autonomic dysfunction: fatigue, anxiety, exercise intolerance
  • If progresses to MR, CHF symptoms

Physical exam

  • Mid-systolic click
  • Late systolic murmur, crescendo into S2
    • Increasing preload decreases murmur while decreasing preload increases murmur
  • May have associated physical features:
    • Pectus excavatum
    • Scoliosis
    • Low body weight
    • Marfanoid habitus

Differential Diagnosis

Valvular Emergencies



  • ECG can show nonspecific changes or arrhythmias
  • CXR usually normal
  • Echocardiography


  • Echocardiogram is gold standard


  • Asymptomatic
    • None
  • Symptoms of autonomic dysfunction
  • Signs of progression to MR
    • Early surgical repair
  • Neuro sequelae
  • Click / Murmur



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