7 Common Mitral Valve Prolapse Symptoms You Should Know

Mitral valve prolapse (MVP) is a condition in which the two valve flaps of the mitral valve don’t close smoothly or evenly, but instead bulge (prolapse) upward into the left atrium during the heart’s contraction. The mitral valve is located between the heart’s left atrium and left ventricle, and it controls blood flow between these two chambers.

While many people with mitral valve prolapse don’t experience any symptoms and may not even know they have the condition, others can experience a range of symptoms that affect their daily life. Understanding these symptoms is crucial for early detection and proper management of the condition. In this comprehensive guide, we’ll explore the most common symptoms associated with mitral valve prolapse, helping you recognize when it might be time to consult with a healthcare professional.

1. Heart Palpitations

Heart palpitations are one of the most frequently reported symptoms of mitral valve prolapse. Palpitations are sensations that feel like your heart is:

• Racing or beating too fast
• Fluttering rapidly
• Pounding or thumping
• Skipping beats or having extra beats
• Flip-flopping in your chest

These sensations can occur at rest or during physical activity and may last from a few seconds to several minutes. While palpitations can be alarming, they’re usually harmless in people with MVP. However, they can be uncomfortable and may cause anxiety. The palpitations occur because the abnormal valve movement can trigger irregular heart rhythms or make you more aware of your normal heartbeat. Some people describe the feeling as if their heart momentarily stops or catches before continuing to beat normally.

Palpitations may be more noticeable when lying down, especially on the left side, or during periods of stress or after consuming caffeine or alcohol.

2. Chest Pain or Discomfort

Chest pain is another common symptom experienced by people with mitral valve prolapse, though it differs from the chest pain associated with coronary artery disease. The chest pain related to MVP typically has these characteristics:

• Sharp or stabbing rather than crushing or squeezing
• Located on the left side of the chest
• Brief in duration, lasting seconds to minutes
• Not necessarily related to physical exertion
• May occur at rest or during emotional stress
• Not typically relieved by rest

The exact cause of chest pain in MVP isn’t fully understood, but it may be related to abnormal tension on the heart muscle from the prolapsing valve leaflets, or it could be due to decreased blood flow to the heart muscle itself. Unlike angina (chest pain from heart disease), MVP-related chest pain doesn’t usually indicate a serious problem, though it can be uncomfortable and concerning for those experiencing it.

It’s important to note that any new or severe chest pain should be evaluated by a healthcare provider to rule out other potentially serious conditions.

3. Fatigue and Low Energy

Many individuals with mitral valve prolapse report feeling unusually tired or lacking energy, even after adequate rest. This fatigue can manifest as:

• Persistent tiredness throughout the day
• Difficulty completing routine activities
• Needing more rest than usual
• Feeling exhausted after minimal physical exertion
• Reduced stamina during exercise or daily tasks

The fatigue associated with MVP may be related to the heart’s reduced efficiency in pumping blood when the valve doesn’t close properly, though in most cases of MVP, the valve function is near normal. Other factors that may contribute to fatigue include anxiety, sleep disturbances from palpitations, or the body’s increased energy expenditure to compensate for the valve abnormality.

This symptom can significantly impact quality of life, affecting work performance, social activities, and overall well-being. The fatigue may vary in intensity from day to day and can be exacerbated by stress, poor sleep, or overexertion.

4. Shortness of Breath (Dyspnea)

Shortness of breath, medically known as dyspnea, can occur in people with mitral valve prolapse, particularly during physical activity or when lying flat. This symptom may present as:

• Difficulty catching your breath during exercise
• Feeling breathless with activities that didn’t previously cause problems
• Needing to prop yourself up with pillows while sleeping
• Sudden episodes of breathlessness
• Feeling like you can’t take a deep breath

In mild cases of MVP, shortness of breath is uncommon, but it can occur if the valve prolapse is more severe and leads to mitral regurgitation (blood leaking backward through the valve). When this happens, the heart has to work harder to pump blood forward, and fluid can back up into the lungs, causing breathing difficulties.

Shortness of breath may also be related to anxiety or panic attacks, which are more common in people with MVP. However, if you experience persistent or worsening shortness of breath, especially if accompanied by other symptoms, it’s essential to seek medical evaluation to determine the underlying cause and appropriate management.

5. Dizziness and Lightheadedness

Feelings of dizziness, lightheadedness, or near-fainting (presyncope) can occur in individuals with mitral valve prolapse. These sensations may include:

• Feeling unsteady or off-balance
• A sensation that the room is spinning (vertigo)
• Feeling faint or like you might pass out
• Lightheadedness when standing up quickly
• Brief episodes of confusion or disorientation

These symptoms can result from several factors related to MVP. In some cases, irregular heart rhythms associated with the condition can temporarily reduce blood flow to the brain. Additionally, some people with MVP have autonomic nervous system dysfunction, which affects blood pressure regulation and can cause orthostatic hypotension (a drop in blood pressure when standing up).

The dizziness may be brief and resolve on its own, or it may be more persistent and interfere with daily activities. Some people find that these symptoms are worse in certain situations, such as in hot environments, after standing for long periods, or during times of stress. While occasional dizziness is usually not serious, frequent or severe episodes, especially those resulting in actual fainting, should be evaluated by a healthcare provider.

6. Anxiety and Panic Attacks

There is a well-documented association between mitral valve prolapse and anxiety disorders, including panic attacks. People with MVP may experience:

• Excessive worry or nervousness
• Sudden episodes of intense fear (panic attacks)
• Rapid heartbeat accompanied by feelings of dread
• Difficulty controlling anxious thoughts
• Physical symptoms of anxiety such as sweating, trembling, or nausea
• Hyperventilation or feeling like you can’t breathe

The relationship between MVP and anxiety is complex and not fully understood. It may be partly due to heightened awareness of heart sensations (like palpitations) that can trigger anxiety, or there may be underlying neurochemical or autonomic nervous system factors that contribute to both conditions.

Panic attacks in people with MVP can include symptoms very similar to cardiac symptoms—chest pain, rapid heartbeat, shortness of breath, and dizziness—which can create a cycle of anxiety about heart health. It’s important to recognize that while MVP can be associated with anxiety, the valve condition itself is usually benign and not life-threatening.

Managing anxiety through stress reduction techniques, counseling, or other approaches recommended by healthcare providers can significantly improve quality of life for those with MVP.

7. Heart Murmur

While not a symptom that you would typically feel yourself, a heart murmur is often the first sign that leads to the diagnosis of mitral valve prolapse. A murmur is an extra or unusual sound heard during a heartbeat, detected by a doctor using a stethoscope. In MVP, the murmur has distinctive characteristics:

• A clicking sound (mid-systolic click) as the valve prolapses
• A whooshing sound (systolic murmur) if blood leaks backward through the valve
• Sounds that may change with body position or activity
• May become louder or softer depending on various factors

The classic finding in MVP is a mid-systolic click followed by a late systolic murmur, which occurs when the mitral valve leaflets prolapse into the left atrium and allow some blood to flow backward (regurgitation). However, some people with MVP have only the click without a murmur, or the murmur may be very soft and difficult to hear.

Doctors can perform specific maneuvers during examination to make the murmur more apparent, such as having you stand up or perform a Valsalva maneuver (bearing down). While you won’t feel the murmur yourself, its detection during a routine physical examination is often what prompts further testing, such as an echocardiogram, to confirm the diagnosis of mitral valve prolapse.

Main Causes of Mitral Valve Prolapse

Understanding what causes mitral valve prolapse can help you better comprehend this condition. The main causes and risk factors include:

Genetic Factors

Mitral valve prolapse often runs in families, suggesting a strong genetic component. If you have a parent or sibling with MVP, you’re at higher risk of developing the condition. Several genetic mutations affecting connective tissue have been identified in families with MVP.

Connective Tissue Disorders

MVP is more common in people with inherited connective tissue disorders that affect the body’s structural proteins. These conditions include:

• Marfan syndrome
• Ehlers-Danlos syndrome
• Osteogenesis imperfecta
• Pseudoxanthoma elasticum

These disorders can cause the valve leaflets to become abnormally stretchy or weakened, leading to prolapse.

Myxomatous Degeneration

This is the most common cause of primary MVP. It involves a weakening and thickening of the valve tissue due to abnormal production or breakdown of connective tissue proteins like collagen. The valve leaflets become more elastic and stretchy than normal, causing them to balloon backward into the atrium.

Age and Gender

MVP can occur at any age but is most commonly diagnosed in people between 20 and 40 years old. While the condition affects both men and women, the prevalence and symptom patterns can differ between sexes. Severe complications are more common in men and older individuals.

Body Build

People with certain body types appear to be at higher risk. MVP is more common in individuals who are thin or have certain physical characteristics such as a narrow chest, straight spine, or low body weight. The condition is also associated with certain skeletal abnormalities like scoliosis or pectus excavatum.

Secondary Causes

In some cases, MVP can be secondary to other conditions, including:

• Rheumatic heart disease
• Coronary artery disease
• Cardiomyopathy
• Previous heart attacks affecting the muscles that control the valve

Frequently Asked Questions

Is mitral valve prolapse dangerous?

For most people, mitral valve prolapse is not dangerous and doesn’t significantly affect life expectancy or quality of life. The majority of people with MVP have no symptoms and require no treatment. However, in rare cases, complications can develop, including severe mitral regurgitation, endocarditis, or irregular heart rhythms. Regular monitoring by a healthcare provider is important to detect any changes in the condition.

Can mitral valve prolapse go away on its own?

No, mitral valve prolapse is a structural abnormality of the heart valve that doesn’t resolve on its own. However, symptoms may come and go or improve over time. Some people who are diagnosed with MVP in childhood or young adulthood may find that symptoms decrease as they age, though the structural abnormality of the valve remains.

When should I see a doctor about MVP symptoms?

You should see a doctor if you experience persistent or severe symptoms such as chest pain, significant shortness of breath, irregular heartbeats that don’t go away, fainting episodes, or symptoms that interfere with your daily activities. Additionally, if you’ve been diagnosed with MVP, you should attend regular follow-up appointments as recommended by your healthcare provider, even if you feel well.

Can I exercise if I have mitral valve prolapse?

Most people with MVP can exercise normally and are encouraged to maintain regular physical activity. Exercise is generally safe and beneficial for cardiovascular health. However, if you have severe MVP with significant mitral regurgitation or have experienced concerning symptoms during exercise, your doctor may recommend certain precautions or limitations. Always consult with your healthcare provider about appropriate exercise guidelines for your specific situation.

Does stress make mitral valve prolapse symptoms worse?

Yes, stress can exacerbate symptoms of mitral valve prolapse. Emotional or physical stress can increase heart rate and blood pressure, making symptoms like palpitations, chest discomfort, and anxiety more noticeable. Stress management techniques such as regular exercise, adequate sleep, relaxation practices, and counseling can help reduce symptom frequency and severity.

How is mitral valve prolapse diagnosed?

MVP is typically diagnosed through a physical examination when a doctor hears a characteristic click or murmur with a stethoscope. The diagnosis is confirmed with an echocardiogram (ultrasound of the heart), which shows the valve structure and function in detail. Other tests may include electrocardiogram (ECG), chest X-ray, or stress tests to evaluate heart rhythm and overall cardiac function.

Can diet affect mitral valve prolapse symptoms?

While diet doesn’t change the structural abnormality of MVP, certain dietary factors can affect symptoms. Reducing caffeine and alcohol intake may help decrease palpitations and anxiety in some people. Staying well-hydrated and maintaining adequate salt intake (unless otherwise directed by your doctor) can help prevent dizziness and low blood pressure. A heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins supports overall cardiovascular health.

Is mitral valve prolapse the same as mitral regurgitation?

No, they’re related but different conditions. Mitral valve prolapse is a structural abnormality where the valve leaflets bulge backward into the atrium. Mitral regurgitation is blood leaking backward through the valve. MVP can cause mitral regurgitation, but not everyone with MVP has regurgitation. Conversely, mitral regurgitation can occur without prolapse from other causes. The presence and severity of regurgitation, rather than prolapse alone, typically determines symptoms and treatment needs.

References:

• Mayo Clinic – Mitral Valve Prolapse
• American Heart Association – Mitral Valve Prolapse
• National Heart, Lung, and Blood Institute – Heart Valve Diseases
• Cedars-Sinai – Mitral Valve Prolapse
• MedlinePlus – Mitral Valve Prolapse