Mitral valve prolapse

The term mitral valve prolapse ( MKP ) refers to a usually congenital (primary) malformation of the mitral valve of the human heart. In this case, the proportions of the mitral valve bulge before during systole into the left atrium. It is found in 2.4% of all people.

Molding

In the primary form you will find a coarsening and fraying edges of the flaps, a dilution of the chordae happens. Accompanying found in approximately 40% of cases, a prolapse of the tricuspid valve, in about 10 % and the aortic and pulmonary valves.

The secondary form may, under a rheumatic or coronary heart disease or as part of the plan of the flap hinge ( Sehnenfadenruptur ) eg occur in endocarditis. The morphological changes described above in the primary form here not found.

Clinic

In most cases the diagnosis is an incidental finding during auscultation ( medium- to spätsystolischer click apically followed by high-frequency crescendo - decrescendo Spätsystolikum ) or echocardiography ( systolic bulging of the sail> 2 mm, thickening > 5 mm). Patients are generally asymptomatic, palpitations do occur. A link to increased incidence of shortness of breath, chest pain, syncope, panic attacks, as described in the past, can not be proved statistically.

Only in 4% of cases there is a significant leakage of the valve ( mitral regurgitation ). Here, signs of heart failure can develop, and it come before relevant cardiac arrhythmias. The likelihood of sudden cardiac death is increased in comparison to the normal population.

Therapy

The MKP usually requires no treatment. Only a severe mitral regurgitation should be treated surgically. In milder forms of impairment should be pay attention to a normotensive blood pressure control.

The risk of endocarditis is in the normal population at 5-7:100.000 patient-years. In a prolapse without insufficiency it is 4,6:100.000 and rises with a significant impairment on 52:100.000. Given these figures, one renounces today endocarditis.

Literature and sources

• Mewis, Riessen, Spyridopoulos (eds): Cardiology compact - Everything for station and board examination. 2 edition. Thieme, Stuttgart, New York 2006, ISBN 3-13-130742-0, pp. 338-340.

• Disease in cardiology
• Disease in pediatric