What is Mitral Valve Prolapse (MPV)

It is also called Barlow’s syndrome or floppy mitral valve. In this condition, a mitral valve leaflet, commonly
the posterior leaflet prolapses into the left atrium during ventricular systole. It is one of the
most common causes of MR. It may be congenital or due to degenerative myxomatous change.

Symptoms

• More common in thin, young women, may be familial.
• The most common symptom is atypical chest pain, usually in left submammary region, stabbing
in quality, may be confused with anginal pain.
• There may be palpitation, dyspnoea, fatigue.

Signs

• Midsystolic click followed by late systolic murmur (cardinal sign).
• Later, signs of MR are found.

Investigation

• Echocardiogram.

Treatment

• If asymptomatic—reassurance, periodic echocardiography.
• Atypical chest pain and palpitation—beta-blocker.
• Significant MR or AF—anticoagulation to prevent thromboembolism (aspirin may be given).
• In severe MR—mitral valve repair or replacement.
• Prophylactic penicillin to prevent infective endocarditis.