Mitral Valve Prolapse Flashcards
What is Mitral Valve Prolapse (MVP)?
A: MVP, also known as floppy mitral valve syndrome, is a valvular heart disorder where the mitral valve leaflet prolapses into the left atrium during systole.
What are some other names for MVP?
A: Floppy mitral valve syndrome, systolic click-murmur syndrome, and billowing mitral leaflets.
MVP often occurs as an isolated condition in which connective tissue disorders?
A: Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome, osteogenesis imperfecta, pseudoxanthoma elasticum, and aneurysms-osteoarthritis syndrome.
What is primary MVP, and how is it different from secondary MVP?
A: Primary MVP involves myxomatous degeneration without connective tissue pathology, while secondary MVP may be multifactorial and is associated with other conditions like Ehlers-Danlos syndrome and Marfan syndrome.
What are common symptoms associated with MVP?
A: Atypical chest pain, palpitations, dyspnea on exertion, exercise intolerance, anxiety, low blood pressure, syncope, and autonomic dysfunction symptoms.
What is a diagnostic sign of MVP on physical examination?
A: A mid-systolic click followed by a late systolic murmur.
How does the murmur of MVP vary with position?
A: The murmur is accentuated when standing or with Valsalva maneuver (click comes earlier, murmur is longer) and diminishes when squatting (click comes later, murmur is shorter).
What distinguishes classic MVP from non-classic MVP?
A: Classic MVP has a leaflet thickness of over 5 mm, whereas non-classic MVP has a leaflet thickness of 0 to 5 mm.
When is surgical intervention indicated for MVP?
A: In symptomatic patients with severe mitral regurgitation, systolic heart failure, or symptom progression, or in asymptomatic patients with mitral regurgitation and systolic heart failure.
What medication is recommended for MVP patients with symptoms of dysautonomia?
A: Beta-blockers, such as propranolol, for symptoms like chest pain and palpitations.
Is prophylactic treatment recommended for MVP patients?
A: Antithrombotic treatment is not recommended for MVP alone.
Endocarditis prophylaxis is necessary for patients with systolic clicks, myxomatosis degeneration, and mitral regurgitation, or other high-risk features like LV dilatation or leaflet thickening.
What factors increase the risk of severe mitral regurgitation in MVP patients?
A: Risk factors include age over 50, hypertension, obesity, moderate-to-severe mitral regurgitation, mitral regurgitation during exercise, echocardiographic findings like leaflet thickness >5 mm, posterior leaflet prolapse, left ventricular enlargement, atrial fibrillation, reduced LV systolic function, and left atrial enlargement.
