Mitral valve prolapse

Alternative names:

Barlow's syndrome; billowing mitral valve; floppy mitral valve; myxomatous mitral valve; prolapsing mitral leaflet syndrome; systolic click-murmur syndrome

Symptoms:

• sensation of feeling the heart beat (palpitations)
• chest pain (unrelated to coronary artery disease or myocardial infarction)
• difficulty breathing after exertion
• fatigue
• cough
• shortness of breath when lying flat (orthopnea)

Note: In some cases, there may be no symptoms or there may be a gradual onset of symptoms.

Signs and tests:

Palpation may reveal a thrill (vibration) over the heart. A stethoscopic of the heart may reveal a distinctive murmur or other abnormal sounds. (The murmur is described as a mid-systolic click followed by a late systolic murmur. This means a click sound is heard midway in the "beating" part of the heartbeat cycle, follwed by a murmur near the end of this time.) The murmur is worse when standing. If fluid backs up into the lungs, there may be signs of congestion of the pulmonary (lung) veins such as crackles. Blood pressure is usually normal.

• An echocardiogram may show mitral valve prolapse.
• Coronary angiography may show MVP or mitral regurgitation.
• Chest X-rays may show fluid in the lungs or lung veins, or an enlarged left atrium.
• An ECG is usually normal but may show arrhythmias such as atrial fibrillation (rapid insufficient contractions).
• Other tests may include ultrasound, chest MRI, radionucleotide scans, or a CT scan of the chest.