Mitral valve prolapse

What is Mitral valve prolapse (MVP)?

MVP is a condition where there is usually a gross redundancy of the mitral valve leaflets which fails coaptation of the leaflets during systole, leading to mitral insufficiency.

How to diagnose MVP in Echocardiogram?

Mitral Valve Prolapse is defined as mitral valve displacement more than 2 mm above mitral annulus in long-axis view (parasternal or apical three chambers).

What is the difference between Classic and Non-Classic MVP?

In non-classic MVP, mitral valve leaflet thickness is 0 mm to 5 mm.

In classic MVP, mitral valve leaflet thickness is more than 5 mm.

Classic MVP is further subdivided into symmetric and asymmetric Type.

Classic asymmetric MVP is further subdivided into flail and non-flail subtypes.

What are other names for Mitral valve prolapse?

• Floppy mitral valve syndrome,
• Systolic click-murmur syndrome, and
• Billowing mitral leaflets

What is primary MVP?

Primary mitral valve prolapse is characterized by myxomatous degeneration in the absence of any connective tissue pathology.

What is Secondary MVP?

Secondary MVP can be multifactorial

Usually seen with Ehler-Danlos Syndrome, Marfan syndrome, polycystic kidney disease, graves’ disease, and pectus excavatum.

Which connective tissue disorders associated with MVP ?

• Marfan syndrome,
• Loeys-Dietz syndrome,
• Ehlers-Danlos syndrome,
• Osteogenesis imperfecta,
• Pseudoxanthoma elasticum,
• Aneurysms-osteoarthritis syndrome

What is the murmur of MVP ?

Mitral valve prolapse murmur – a mid-systolic click, followed by a late systolic murmur heard best at the apex

What is the effect of handgrip maneuver on murmur of MVP and HOCM?

• Murmur of MVP is similar to the murmur of hypertrophic cardiomyopathy.
• A mid-systolic click is a diagnostic of MVP.
• The handgrip maneuver increases the murmur of MVP and decreases murmur of hypertrophic cardiomyopathy.
• The handgrip maneuver also decreases the duration of the murmur and delays the timing of the mid-systolic click in MVP.

What are the complications of MVP?

• Progression to severe mitral regurgitation
• Infective endocarditis
• Atrial fibrillation
• Stroke
• Sudden death