Mitral valve prolapse (MVP), a very common heart condition, occurs when one of the heart's valves doesn't work properly. MVP can be frightening because it involves the heart and can occur with sharp chest pain, but it is not a critical heart problem.
Because MVP often doesn't produce any symptoms or interfere with everyday life, in many cases it isn't diagnosed until adulthood. But with kids who are diagnosed, it's important to know what symptoms can go with MVP, so you can distinguish them from signs of any other more serious heart issues.
To understand mitral valve prolapse, it's helpful to review some basics about the way a healthy heart works.
The mitral valve is located between the left atrium and the left ventricle and helps control the flow of blood as it passes from the left atrium into the left ventricle. The valve has two flaps of tissue — known as leaflets — that open and close together like a pair of swinging doors. Each time the heart beats, the left ventricle pumps blood out to the body and the flaps of the mitral valve swing shut to prevent the blood in the ventricle from flowing backward into the left atrium.
In cases of MVP, one or both of the mitral valve's leaflets may flop back and bulge into the atrium when they are shut, a bit like a balloon. This may occur because one of the flaps is abnormally shaped or a little too large.
Sometimes, when the flaps do not close evenly, blood is allowed to leak back into the left atrium. This is called mitral regurgitation. In all of us, a tiny amount of mitral regurgitation may be normal. When there is more than a little leakage, the doctor may hear a whooshing sound — a heart murmur — between the normal lub-dub sounds of the heartbeat. (Because of these sounds, MVP is sometimes called click-murmur syndrome, floppy valve syndrome, or balloon mitral valve.)
In most cases, the cause of MVP is unknown. Sometimes kids are born with the condition. In other cases, it develops after some sort of inflammatory condition, like endocarditis (infection of the inner lining of the heart) or rheumatic fever (inflammation that can affect the joints and the heart).
MVP may be diagnosed in people who have other health conditions that affect the body's connective tissues, such as Marfan syndrome. Some research has shown that kids with MVP might be more likely to also have an arrhythmia, an irregular heartbeat.
Many people with MVP have no symptoms and no complaints. In some cases, though, the flaps of the mitral valve make a clicking sound when they close, like when you flick or snap a towel, and it is simply called a "click." A doctor might be able to hear this noise when listening to the heart with a stethoscope and discover MVP that way.
Someone who has MVP and mitral regurgitation also may have a heart murmur, the sound caused by some blood moving backward into the left atrium. When a click and murmur are heard together, the click happens first (as the flaps close and flop back), followed by the murmur (the noise of the whirling blood as it leaks back into the atrium through the improperly closed valve).
Kids with MVP might experience:
The chest pain is often described as sharp but can vary from person to person. And it isn't always clear whether chest pain in kids is caused by the MVP or by something else, such as stomach reflux.
Chest pain in kids is not usually dangerous. However, call your doctor if your child has chest pain that:
In most cases, MVP is diagnosed during a routine exam when a doctor listens to the heart with a stethoscope and hears a different sound. If the doctor hears a click or a murmur that indicates MVP, your child may be referred to a pediatric cardiologist, a doctor who specializes in diagnosing and treating heart conditions in kids.
The cardiologist will perform a thorough physical exam and listen to the heart. Then he or she may order tests — including an echocardiogram (echo) and an electrocardiogram (EKG or ECG) — to find out what's causing the sound. An echo uses sound waves to create a picture of the heart and its blood flow, and an EKG records electrical activity produced by the heart. If a child has MVP, the bulging valve flaps will probably be seen on the echo when the heart beats.
Kids who are diagnosed with MVP usually require no medical treatment. In some cases where MVP causes significant regurgitation, blood pressure medication is prescribed to control how hard the heart muscle must work. (With blood leaking back into the atrium, the heart works harder to pump the normal amount of blood out to the body.)
A child who has an arrhythmia (an abnormal heart rhythm) in addition to MVP may need to take medicine to help regulate the heart's rhythm. However, this is not common in kids.
Leakage due to MVP may continue over years; very rarely, a child might need surgery to repair a very leaky mitral valve.
In a child with MVP with regurgitation (leaking), there is a small risk of a bacterial infection of the heart valve (infective endocarditis). It very rarely happens during childhood. Many times the bacteria that cause this kind of infection start out living in the mouth and from there enter the bloodstream through the gums and then, even more rarely, cause the infection.
For many years, it was recommended to give a dose of antibiotics before dental work and surgical procedures as a precaution. Following a review and published report by The American Heart Association in 2007, it is no longer recommended that antibiotics be given, as they were not found to reliably protect the patient.
Instead, you and your child should focus your attention on good mouth care:
Your child's cardiologist will advise you if there are reasons to do something other than follow this guideline.
Kids with MVP who have no other medical conditions typically require no special care. A child with MVP who plays competitive sports will be able to continue doing so as long there's no mitral regurgitation or active symptoms from the MVP. A child who does have regurgitation or symptoms will have to be cleared by the doctor to participate in sports. This may involve some additional tests.
Although any heart condition can be frightening, mitral valve prolapse likely will not have any impact on your child's everyday life and activities. If you have any questions or concerns, speak with your doctor.
Reviewed by: Paul C. Anisman, MD
Date reviewed: September 2011
|National Heart, Lung, and Blood Institute (NHLBI) The NHLBI provides the public with educational resources relating to the treatment of heart, blood vessel, lung, and blood diseases as well as sleep disorders.|
|Congenital Heart Information Network The Congenital Heart Information Network's goal is to provide information and resources to families of children with congenital and acquired heart disease, adults with congenital heart defects, and the professionals who work with them.|
|American Heart Association This group is dedicated to providing education and information on fighting heart disease and stroke. Contact the American Heart Association at: American Heart Association|
7272 Greenville Ave.
Dallas, TX 75231
|American Academy of Pediatrics (AAP) The AAP is committed to the health and well-being of infants, adolescents, and young adults. The website offers news articles and tips on health for families.|
|American Academy of Family Physicians This site, operated by the American Academy of Family Physicians (AAFP), provides information on family physicians and health care, a directory of family physicians, and resources on health conditions.|
|Heart Murmurs and Your Child A heart murmur diagnosis is extremely common. Most murmurs are not a cause for concern and do not affect a child's health.|
|Heart Murmurs Everyone's heart makes sounds, but some people have hearts that make more noise than others. Usually, however, these heart murmurs don't mean anything is wrong. Find out more about these mysterious murmurs.|
|Ventricular Septal Defect Ventricular septal defect, or VSD, is a heart condition that a few teens can have. Find out what it is, how it happens, and what doctors do to correct it.|
|Marfan Syndrome Marfan syndrome affects the body's connective tissue and can cause problems in the eyes, joints, and heart. But teens with Marfan syndrome can live normal lives. Find out how in this article.|
|Marfan Syndrome Marfan syndrome is a disorder that affects the body's connective tissue. This causes problems in many systems of the body, but especially the heart, eyes, and bones.|
|Mitral Valve Prolapse Mitral valve prolapse is a heart problem that's usually minor.|
|Arrhythmias Arrhythmias are abnormal heart rhythms usually caused by an electrical "short circuit" in the heart. Many don't require treatment; however, some need to be evaluated and treated by a doctor.|
|Arrhythmias Arrhythmias are abnormal heartbeats usually caused by an electrical "short circuit" in the heart. Many are minor and not a significant health threat, but others can indicate a more serious problem.|
|Atrial Septal Defect Atrial septal defect, or ASD, is a heart condition that teens can have. In most cases, ASDs are diagnosed and treated successfully with few or no complications.|
|Atrial Septal Defect Atrial septal defect (ASD) - also known as a "hole in the heart" - is a type of congenital heart disease. Fortunately, most ASDs are diagnosed and treated successfully.|
|Heart and Circulatory System The heart and circulatory system (also called the cardiovascular system) make up the network that delivers blood to the body's tissues.|
|Heart and Circulatory System The heart and circulatory system are our body's lifeline, delivering blood to the body's tissues. Brush up on your ticker with this body basics article.|
|If Your Child Has a Heart Defect Congenital heart defects are relatively common, affecting almost 1 in every 100 newborns in the United States.|
|Congenital Heart Defects Congenital heart defects involve abnormal or incomplete development of the heart. Learn about the different types of congenital heart defects.|
|Ventricular Septal Defect Ventricular septal defect (VSD) - also known as a "hole in the heart" - is a congenital heart defect. Fortunately, most VSDs are diagnosed and treated successfully.|
|Coarctation of the Aorta Coarctation of the aorta is a treatable congenital defect in which a child's aorta is narrowed at some point.|
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