Very few conditions have caused as much controversy and frustration over the years as mitral valve prolapse (MVP). Most people have no doubt heard about reports of devastating complications that may be associated with Mitral Valve Prolapse, such as dangerous heart rhythms, heart infections, need for emergency heart surgery, and even dying suddenly. Many patients who have been told they have Mitral Valve Prolapse are literally convinced they are going to die on a daily basis, whereas in fact most patients with Mitral Valve Prolapse don’t even know they have it! On the other hand, if anyone with Mitral Valve Prolapse asks their physician what the significance of their Mitral Valve Prolapse is, they will inevitably be greeted with the response, “It’s normal, you shouldn’t think twice about it; in fact your symptoms have nothing to do with it, so forget you have it!” These contradictions and inconsistencies have led to a great deal of confusion for patients and physicians alike over the years. This confusion has been highlighted in a number of articles published in leading medical journals over the years. So can Mitral Valve Prolapse cause death?
Why the Controversy and Confusion?
There are many reasons for this confusion; I’ll try to explain some of them. There was a time when the imaging techniques for the heart were not refined and literally everyone getting an echocardiogram was labeled with Mitral Valve Prolapse. The problem was made worse by the fact that those people referred for the echocardiograms were of course those with symptoms (for all we know if we had done echocardiograms on people without symptoms they would have been just as likely to been told they had Mitral Valve Prolapse!). This unfortunately led to a great deal of over-diagnosis of MVP, and had the unfortunate consequence of multiple symptoms and findings being attributed to Mitral Valve Prolapse. By the time we had developed important concepts and come up with the correct criteria for Mitral Valve Prolapse it was too late as we had decades of research that had associated the incorrect old version of Mitral Valve Prolapse with a large spectrum of incorrect symptoms and findings.
When the new diagnosis of Mitral Valve Prolapse was applied to patients with many of the same symptoms and findings as associated with the old Mitral Valve Prolapse, it was in fact realized that most of the patients did not in fact have MVP, and therefore a lot of physicians became dismissive of Mitral Valve Prolapse altogether. Unfortunately many patients had been diagnosed with Mitral Valve Prolapse in the past, and due to what they had been told could not accept that Mitral Valve Prolapse was unlikely to be related to the majority of their symptoms. Later many realized they in fact had a condition known as dysautonomia. So we are still wondering, can Mitral Valve Prolapse cause death?
So What’s the Deal – Dangerous or Not Dangerous?
Since we developed the correct criteria for diagnosis of MVP, there has been much research conducted to determine true associated complications of the disease. Mitral Valve Prolapse it turns out has different forms and shapes. First and foremost is the true diagnosis of Mitral Valve Prolapse, whereby there is clear prolapse of the valve in to the top chamber of the heart in keeping with guidelines. If that is not present, there is no Mitral Valve Prolapse.
Of the people with mitral valve prolapse there are those with simple prolapse and there are those with thickened and severely prolapsing valves. Whereas those with simple prolapse, which is the overwhelming majority of Mitral Valve Prolapse patients, likely have no greater risk then the general population and can probably be considered a variant of normal to some degree.
Then there are those with more complex prolapse and thickened redundant valves. These patients do have some associated risks that include the need to have to undergo surgery to correct a severely leaky valve and also arrhythmias. The key is to identify those people at high risk for complications, try to prevent those complications, and in those people with a leaky valve, to follow them closely to make sure that if they ever need surgery, it is done in a timely manner.
So Can Mitral Valve Prolapse Cause Death?
The answer is short in that it is similar to the saying, you are more likely to be hit by a car while trying to cross the road, so if you have Mitral Valve Prolapse I really wouldn’t advise you spend time worrying about dropping dead because you are not really at increased risk compared to someone without Mitral Valve Prolapse! For those with complex Mitral Valve Prolapse, if you have no significant leakiness on your echocardiogram, and a normal looking EKG then all you need is to continue routine check ups with your physician from time to time to listen for the development of a murmur. If you do have significant leakiness of the valve, then still don’t worry, the key to doing just fine is close follow up to ensure the heart is functioning well and the optimal timing of surgical correction if it is ever required.
So can Mitral Valve Prolapse Cause Death? – Possibly, but it is likely not worth worrying about!