Definition
A mitral valve prolapse is a protrusion and protrusion of the so-called mitral sail into the left atrium. The mitral valve is one of the four valves of the human heart and is most frequently affected by abnormalities and diseases. One speaks of a mitral valve prolapse when the valve protrudes more than 2mm into the left atrium. Approximately 2-3% of adults have mitral valve prolapse, but many of them have no symptoms, the diagnosis is usually random and does not require further treatment.
Cause
The cause of a mitral valve prolapse is largely unknown. A protrusion of the mitral valve is caused by instability of the sutures that hold the valve. Why these threads suddenly lose stability and traction is not known.
In some cases, which are rather rare, a so-called Marfan syndrome can lead to the development of a mitral valve prolapse. This is a disease of the connective tissue of the whole body, which can lead to instability of the heart valve, among other things. Mitral valve prolapse is rarely caused by infections such as bacterial endocarditis (inflammation of the inner wall of the heart). Sometimes, after a heart attack, a tearing of the sutures that hold the heart valve in its stable position can occur, which can also lead to an acute protrusion of the mitral valve.
Diagnosis
The diagnosis of a mitral valve prolapse is usually made by an ultrasound examination of the heart. This procedure, also known as echocardiography, is performed by an internist specializing in cardiology. During this examination he can see and assess not only the thickness of the heart wall and the ejection capacity of the heart, but also the position and condition of all four heart valves.
In the case of a mitral valve prolapse, he can see a clear protrusion of the valve at each heart action. Sometimes, a severe prolapse leads to a reduced ability of the valve to close, which then results in blood reflux. The cardiologist would also see this.
The reason why a mitral valve prolapse is not diagnosed for a long time is because it does not initially cause any symptoms. Complaints are only triggered when the prolapse is very severe. If the protrusion results in a reduced ability to close the valve, this valve disease can also be diagnosed by the physician’s auscultation.
Auscultation refers to the doctor’s listening to the lungs and heart. Auscultation is a very old diagnostic procedure, but it still has a wide diagnostic range. Especially when auscultating the heart, sometimes even the smallest valve defects can be diagnosed early.
First, the standing or sitting patient is listened to at four fixed points above the heart. Each point represents one of the four heart valves. In the case of the mitral valve, he would apply the stethoscope to the left chest wall in the upper third.
A prolapse of the mitral valve has no effect on the flow properties of the blood for a long time. During this time, the auscultation will not bring any noticeable findings. However, if the bulge of the mitral valve increases and protrudes too far into the left atrium, additional blood turbulence will occur with every heartbeat.
Furthermore, even in the case of a severe prolapse, the mitral valve may not be able to close completely, which can lead to a reflux of blood. Both the turbulence and the reflux of blood lead to an additional noise that the doctor can hear on the left side of the chest wall. If he or she detects this heart murmur, they already know that it is a valve problem of the mitral valve. A reliable diagnosis is then always made by means of an ultrasound examination of the heart, which can show not only the type of valve disease but also its severity and its influence on the blood flow.
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