Mitral Valve Prolapse (MVP) - Diagnosis

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How is mitral valve prolapse diagnosed and evaluated?

Examination of the patient reveals characteristic findings unique to mitral valve prolapse. Using a stethoscope, a clicking sound is heard soon after the ventricle begins to contract. This clicking is felt to reflect tightening of the abnormal valve leaflets against the pressure load of the left ventricle. If there is associated leakage (regurgitation) of blood through the abnormal valve opening, a "whooshing" sound (murmur) can be heard immediately following the clicking sound.

Echocardiography (ultrasound imaging of the heart) is the most useful test for mitral valve prolapse. Echocardiography can measure the severity of prolapse and the degree of mitral regurgitation. It can also detect areas of infection on the abnormal valves. Valve infection is called endocarditis and is a very rare, but potentially serious complication of mitral valve prolapse. Echocardiography can also evaluate the effect of prolapse and regurgitation on the functioning of the muscles of the ventricles.

Abnormally rapid or irregular heart rhythms can occur in patients with mitral valve prolapse, causing palpitations. A 24-hour Holter monitor is a device that takes a continuous recording of the patient's heart rhythm as the patient carries on his/her daily activities. Abnormal rhythms occurring during the test period are captured and analyzed at a later date. If abnormal rhythms do not occur every day, the Holter recording may fail to capture the abnormal rhythms. These patients then can be fitted with a small "event-recorder" to be worn for up to several weeks. When the patient senses a palpitation, an event button can be pressed to record the heart rhythm prior to, during, and after the palpitations.

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