Feature Article

Mitral valve prolapse: its relevance in general practice

David EL Wilcken

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Abstract

Important issues in patients with mitral valve prolapse include bacterial endocarditis prophylaxis when there is mitral regurgitation and closer surveillance of patients who are aged 50 years and over.

Key Points

  • Mitral valve prolapse (MVP) is characterised by an early systolic click, with or without an early systolic murmur audible at the mitral area.
  • It is present in about 3 to 4% of the adult population and is largely benign.
  • The diagnosis is confirmed by echocardiography.
  • When a patient has a systolic murmur of mitral regurgitation, antibiotic prophylaxis is indicated for tooth extractions and surgical procedures.
  • The principal complications of MVP occur infrequently, and usually after the age of 50 years. They include progressive mitral regurgitation, chordal rupture, atrial fibrillation and bacterial endocarditis.
  • Mitral valve repair is usually indicated only for severe mitral regurgitation.

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