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Treatments and drugs
By Mayo Clinic staffMost people with mitral valve prolapse, particularly people without symptoms, don't require treatment. However, if you have symptoms, your doctor may recommend medications or surgery, depending on the severity of your condition.
Medications
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.
- Aspirin. If you have mitral valve prolapse and a personal or family history of strokes, your doctor might prescribe aspirin to reduce the risk of blood clots.
- Prescription anticoagulants (blood thinners). These medications — warfarin (Coumadin) is commonly used — prevent your blood from clotting. 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.
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 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, there are two main options — repair or replacement of the mitral valve. Both valve repair and replacement require open heart surgery. Both procedures require significant recovery time.
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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 your 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 also can 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 ring around the valve (annulus). This is called an annuloplasty. It is important to ensure that your surgeon is experienced in performing mitral valve repair.
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Valve replacement. Valve replacement is done when valve repair isn't possible. In valve replacement surgery, the damaged mitral valve is replaced by an artificial (prosthetic) valve. The two types of artificial valves are mechanical and tissue.
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's heart 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.
Precautions during pregnancy
If you're pregnant and have mitral valve prolapse, your chances of a successful, uncomplicated pregnancy are good. Even so, doctors sometimes recommend antibiotics during childbirth if there's a risk of an infection that could affect the mitral valve.
- Sorrentino MJ. Definition and diagnosis of mitral valve prolapse. http://www.uptodate.com/home/index.html. Accessed Jan. 28, 2011.
- Mitral valve and mitral valve prolapse. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4717. Accessed Jan. 31, 2011.
- Mitral valve prolapse. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/mvp/mvp_all.html. Accessed Jan. 31, 2011.
- Taub CC, et al. Mitral valve prolapse in Marfan syndrome: An old topic revisited. Echocardiography. 2008;e[#]. http://www3.interscience.wiley.com/journal/121536695/abstract?CRETRY=1&SRETRY=0. Accessed Jan. 28, 2011.
- Sorrentino MJ. Arrhythmic complications of mitral valve prolapse. http://www.uptodate.com/home/index.html. Accessed Jan. 28, 2011.
- Sorrentino MJ. Nonarrhythmic complications of mitral valve prolapse. http://www.uptodate.com/home/index.html. Accessed Jan. 28, 2011.
- Nishimura RA. ACC/AHA guideline update on valvular heart disease: Focused update on infective endocarditis. Circulation. 2008;118:887.
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