Diagnosis

Doctors may diagnose mitral valve prolapse at any age. Your doctor is most likely to diagnose mitral valve prolapse while listening to your heart with a stethoscope during a physical examination.

If you have mitral valve prolapse, your doctor may hear a clicking sound, which is common with this condition. Your doctor may also detect a heart murmur, which would be due to blood leaking back into the left atrium.

Tests

Other tests that may be used to evaluate your heart may include:

  • Echocardiogram. An echocardiogram is a noninvasive ultrasound evaluation of your heart. It's usually done to confirm the diagnosis and determine the severity of your condition.

    This test uses high-frequency sound waves to create images of your heart. It helps doctors see the flow of blood through your mitral valve and measure the amount of blood leakage (regurgitation).

    Your doctor may recommend a transesophageal echocardiogram. In this test, your doctor inserts a flexible tube with a small device (transducer) attached into your throat and down into your esophagus — the tube that connects the back of your mouth to your stomach. From there, the transducer can be positioned to obtain more-detailed images of your heart and mitral valve.

  • Chest X-ray. A chest X-ray shows a picture of your heart, lungs and blood vessels and can help your doctor make a diagnosis. It can help show if your heart is enlarged.
  • Electrocardiogram (ECG). In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat.

    An ECG records these electrical signals and can help your doctor detect irregularities in your heart's rhythm.

  • Stress test. Your doctor may order a stress test to see if mitral valve regurgitation limits your ability to exercise. In a stress test, you exercise or take certain medications to increase your heart rate and make your heart work harder.

    You may also have a stress test if your doctor is trying to determine if you have another condition such as coronary artery disease.

  • Coronary angiogram. This test uses X-ray imaging to see your heart's blood vessels. It isn't generally used to diagnose mitral valve prolapse but may reveal the condition when you're being tested for another suspected diagnosis.

    In some cases, your doctor may recommend a coronary angiogram to gather more information about the severity of your condition.

Treatment

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.

Medications

Medications can treat mitral valve prolapse-related 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.
  • Water pills (diuretics). Your doctor may prescribe diuretics to drain fluid from your lungs.
  • Heart rhythm medications. If you have an arrhythmia, your doctor may prescribe a medication to treat it, such as propafenone (Rythmol SR), sotalol (Betapace, Sorine, Sotylize), flecainide and amiodarone (Pacerone). The medications 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.
  • Blood thinners. If you have atrial fibrillation, a history of heart failure or a history of strokes, your doctor may suggest a blood thinner to prevent your blood from clotting. They include warfarin (Coumadin, Jantoven), heparin, dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa).

    Blood thinners can have dangerous side effects, however, and must be taken exactly as prescribed.

Surgery

Though most people with mitral valve prolapse don't need surgery, your doctor may suggest surgical treatment if you have severe mitral valve regurgitation, whether you have symptoms or not.

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.

Surgery involves 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.

For most people, mitral valve repair is the preferred surgical treatment. During surgery, your surgeon will modify your own valve to stop backward blood flow by reconnecting the flappy valve tissue or by removing excess tissue. Your surgeon may also reinforce the ring around the heart valve to prevent blood from leaking backward.

If mitral valve repair isn't possible, your surgeon may replace it with an artificial valve that is man-made (mechanical) or is made from human tissue or taken from cows or pigs.

Mechanical valves can last a lifetime but you'll need to take a blood thinner to prevent blood clots from forming on the valve. If a blood clot broke free, it could cause a stroke. You generally won't need to take a blood thinner with a valve made from human or animal tissue, but those valves only last about 10 years.

Transcatheter valve therapy

If you have severe mitral regurgitation and can't have surgery, your doctor may recommend a less invasive approach called transcatheter valve therapy. The new technique allows your doctor to repair a valve by implanting a device using a tube (catheter) inserted in a blood vessel in your groin and guided to your heart.

Antibiotics seldom recommended

Doctors used to recommend that some people with mitral valve prolapse take antibiotics before certain dental or medical procedures. However, the American Heart Association has said antibiotics are no longer necessary in most cases for someone with mitral valve regurgitation or mitral valve prolapse.

If you've been told to take antibiotics before any procedures in the past, check with your doctor about whether it's still necessary.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lifestyle and home remedies

Most people with mitral valve prolapse lead normal, productive and symptom-free lives.

Doctors generally won't recommend restrictions on your lifestyle or any limitations on your personal exercise or dietary program. However, ask your doctor if he or she recommends any changes to your lifestyle. If you have severe mitral valve regurgitation, your doctor may recommend certain exercise limitations.

Your doctor may recommend regular follow-up visits to evaluate your condition.

Preparing for your appointment

Because appointments can be brief, and because there's often a lot to discuss, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment and know what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to mitral valve prolapse.
  • Write down key personal information, including a family history of heart disease, heart defects, genetic disorders, strokes, high blood pressure or diabetes, and any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements that you're taking.
  • Take a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Be prepared to discuss your diet and exercise habits. If you don't already follow a diet or exercise routine, be ready to talk to your doctor about any challenges you might face in getting started.
  • Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For mitral valve prolapse, some basic questions to ask your doctor include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes for my symptoms or condition?
  • What kinds of tests will I need?
  • Do I need treatment? What kind?
  • What are the alternatives to the primary approach that you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • Should I see a specialist?
  • If I need surgery, which surgeon do you recommend for mitral valve repair?
  • Is there a generic alternative to the medicine you're prescribing for me?
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Feb. 07, 2020
  1. Pislaru S, et al. Definition and diagnosis of mitral valve prolapse. https://www.uptodate.com/contents/search. Accessed Dec. 4, 2019.
  2. Mitral valve prolapse. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/mvp/. Accessed Dec. 4, 2019.
  3. Ferri FF. Mitral valve prolapse. In: Ferri's Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 4, 2019.
  4. Kellerman RD, et al. Mitral valve prolapse. In: Conn's Current Therapy 2019. Elsevier; 2019. https://www.clinicalkey.com. Accessed Dec. 4, 2019.
  5. Nishimura RA, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2017; doi:10.1016/j.jacc.2017.03.011.
  6. Problem: Mitral valve prolapse. American Heart Association. http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Problem-Mitral-Valve-Prolapse_UCM_450441_Article.jsp#.WDJJF9UrJ0w. Accessed Dec. 4, 2019.
  7. Atrial fibrillation medications. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/Atrial-Fibrillation-Medications_UCM_423781_Article.jsp#.WDJKytUrJ0w. Accessed Dec. 4, 2019.
  8. Warning signs of a heart attack. American Heart Association. https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack. Accessed Dec. 4, 2019.
  9. Shiota T. Role of echocardiography for catheter-based management of valvular heart disease. Journal of Cardiology. 2017; doi:10.1016/j.jjcc2016.09.015.
  10. AskMayoExpert. Mitral regurgitation (adult). Mayo Clinic; 2018.
  11. Nalliah CJ, et al. Mitral valve prolapse and sudden cardiac death: A systematic review and meta-analysis. Heart. 2019; doi:10.1136/heartjnl-2017-312932.
  12. Mazine A, et al. Systematic review and meta-analysis of chordal replacement versus leaflet resection for posterior mitral leaflet prolapse. Journal of Thoracic and Cardiovascular Surgery. 2018; doi:10.1016/j.jtcvs.2017.07.078.
  13. Connolly HM (expert opinion). Mayo Clinic. Jan. 5, 2020.