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Mitral Valve Prolapse vs. Mitral Regurgitation: What’s the difference?

Cardiologists are often asked what the difference is between mitral valve prolapse and mitral regurgitation. Although related, both conditions involve the mitral valve, one of the most important valves of the heart.

Are Mitral Valve Prolapse and Regurgitation the Same?

No, mitral valve prolapse and mitral regurgitation are not the same, but they are related.

  • Mitral valve prolapse (MVP) consists of the bulging or “prolapse” of the valve leaflets-the flaps that open and close-back into the left atrium during heart contractions. This takes place because the tissue of the valve is abnormally thickened or stretchy, which renders it unable to close tightly.
  • Mitral regurgitation is the leakage of the blood in a backward direction through the mitral valve. This results from the incomplete closure of the mitral valve leaflets. MVP may cause regurgitation, but not always so. A number of people with MVP have no significant leakage, whereas others, at some point in their lives, start developing mild to severe leakage.

How are the conditions related?

Each one of them is thus unique in its own range of severity, and none of these conditions is worse than others. Mitral regurgitation depends on the severity of the leakage because it affects the efficiency with which the heart pumps blood. Over time, this may lead to such complications as heart failure, pulmonary hypertension, or atrial fibrillation (AFib). Many people have a little bit of leakage we would consider trace, which is largely insignificant. When the regurgitation is mild, moderate, or severe, it is to be taken seriously as it can progress to heart failure.

Mitral valve prolapse represents a structural abnormality of the valve, and though it does not always result in the appearance of symptoms, it can lead to mitral regurgitation if the valve does not shut well. Not every person with MVP will develop significant regurgitation, but the prolapse increases the likelihood of leakage. If prolapse is associated with mitral regurgitation, the condition can become very serious. Surgery may then be indicated to repair or replace the mitral valve, especially when regurgitation is symptomatic and produces fatigue, dyspnea, or arrhythmias.

What problems can mitral valve prolapse cause?

Patients with MVP may experience chest pain, shortness of breath, palpitations, and has been associated with anxiety. It is usually unrelated to coronary artery disease or heart attack; it is painful nonetheless. The conditions associated with MVP include arrhythmias, such as Atrial Fibrillation (AFib), ventricular tachycardia (VT), and supraventricular tachycardia (SVT). 

What can you do if you have MVP?

If your doctor suspects that you have MVP, a number of key steps will likely be taken in order to confirm the diagnosis and settle the severity of the condition.

Echocardiogram: This is the best test for diagnosing MVP. It is a noninvasive, painless ultrasound test that uses sound waves to create images of your heart. It shows the structure and motion of the mitral valve well and helps determine whether or not the valve is prolapsed.

Electrocardiogram (ECG): An ECG records the electrical activity of your heart and may be ordered if your doctor suspects that MVP is causing irregular heart rhythms (arrhythmias). This test can identify heart stress indicators brought on by valve issues.

If you have symptoms, such as palpitations, your doctor may ask you to wear a Holter monitor for 24 to 48 hours or a Mobile Cardiac Telemetry (MCT) for 4-5 days because of associated arrhythmias. The purpose of wearing a home telemetry monitor is so your doctor can identify if any arrhythmias are occurring in real time and gives us a better picture, because you have it for more than 1 day. Depending on the condition and severity, treatment after diagnosis would vary. Mild cases may just be managed with regular follow-up, while severe ones require medication or surgery.

Cardiologists diagnose such conditions as mitral valve prolapse or mitral regurgitation with the help of these specialized tests and assessments. If you suspect something in your heart, schedule a cardiology consultation today and get the best care for your peace of mind.