Most people with mitral valve prolapse, particularly people without symptoms, don't require treatment.
If you have mitral valve regurgitation but don't have symptoms, your doctor may suggest you return regularly for follow-up examinations to monitor your condition, depending on the severity of your condition.
However, if you have symptoms and if a significant amount of blood is leaking through the mitral valve, your doctor may recommend medications or surgery, depending on the severity of your condition.
If you develop symptoms, your doctor might prescribe certain medications to treat mitral valve prolapse-related chest pain, heart rhythm abnormalities or other complications. Some medications you might be prescribed include:
- Beta blockers. These drugs help prevent irregular heartbeats by making your heart beat more slowly and with less force, which reduces your blood pressure. Beta blockers also help blood vessels relax and open up to improve blood flow.
- Diuretics. Your doctor may prescribe water pills (diuretics) to drain fluid from your lungs.
- Heart rhythm medications. Your doctor may prescribe an antiarrhythmic medication, such as flecainide (Tambocor), amiodarone (Cordarone, Pacerone), and propafenone (Rythmol, Rythmol SR). Antiarrhythmics help control your heart rhythm by normalizing electrical signals in heart tissue.
- Aspirin. If you have mitral valve prolapse and a history of strokes, your doctor might prescribe aspirin to reduce the risk of blood clots.
Prescription anticoagulants (blood thinners). These medications — such as warfarin (Coumadin), heparin, dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa) — prevent your blood from clotting if you have had irregular heart rhythms, such as atrial fibrillation.
If you have atrial fibrillation, a history of heart failure or a history of strokes, your doctor may suggest these drugs. They can have dangerous side effects, however, and must be taken exactly as prescribed.
Though most people with mitral valve prolapse don't need surgery, your doctor may suggest surgical treatment if you have severe mitral valve regurgitation with or without symptoms.
Severe mitral valve regurgitation can eventually cause heart failure, preventing your heart from effectively pumping blood. If regurgitation goes on too long, your heart may be too weak for surgery.
If your doctor suggests surgery, he or she may suggest repairing or replacing the mitral valve. Valve repair and replacement may be performed using open-heart surgery or minimally invasive surgery. Minimally invasive surgery involves smaller incisions and may have less blood loss and a quicker recovery time than open surgery.
Valve repair. Mitral valve repair is a surgery that preserves your own valve. For most people with mitral valve prolapse, this is the preferred surgical treatment to correct the condition.
Your mitral valve consists of two triangular-shaped flaps of tissue called leaflets. The leaflets of the mitral valve connect to the heart muscle through a ring called the annulus.
The surgeon can modify the original valve (valvuloplasty) to eliminate backward blood flow. Surgeons can also repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly.
Sometimes repairing the valve includes tightening or replacing the annulus. This is called an annuloplasty. It is important to ensure that your surgeon is experienced in performing mitral valve repair.
Valve replacement. Your surgeon may perform a valve replacement if valve repair isn't possible. In valve replacement surgery, the damaged mitral valve is replaced by an artificial (prosthetic) valve. Artificial valves are mechanical or tissue valves.
Mechanical valves may last a long time. However, if you have a mechanical valve, you must use an anticoagulant medication, such as warfarin (Coumadin), for the rest of your life to prevent blood clots from forming on the valve. If a blood clot forms on the valve and breaks free, it could travel to your brain and cause a stroke.
Tissue valves are made from animal tissue such as a pig or cow valve. These kinds of valves are called bioprostheses. They may wear out over time and need replacement. However, an advantage of the tissue valve is that you don't have to use long-term anticoagulant medication.
Antibiotics seldom recommended
Doctors used to recommend that some people with mitral valve prolapse take antibiotics before certain dental or medical procedures to prevent endocarditis but not anymore.
According to the American Heart Association, antibiotics are no longer necessary in most cases for someone with mitral valve regurgitation or mitral valve prolapse.
Still, if you've been told to take antibiotics before any procedures in the past, check with your doctor whether that's still necessary.
Potential future treatments
Researchers are studying new techniques to repair or replace a valve using a tube (catheter) inserted in a blood vessel in your groin and guided to your heart.