FABROA, MARIA JESSICA ERLINDA P.

BSN III

MITRAL VALVE PROLAPSE NARRATIVE PATHOPHYSIOLOGY

Mitral valve prolapse is a deformity that usually produces no symptoms. It progresses

and can result in sudden death. This condition occurs in up to 2.5% of the general population

and twice as frequently in women than in men (Delling & Vassan, 2014; Mann, Zipes,

Bonow, et al., 2015). The cause or etilogy may be an inherited connective tissue disorder

resulting in enlargement of one or both of the mitral valve leaflets, but in many cases the

cause is unknown. The annulus often dilates; chordae tendineae and papillary muscles may

elongate or rupture.

The pathophysiology of mitral valve prolapse, is a portion of one or both mitral valve

leaflets balloons back into the atrium during systole. Rarely, ballooning stretches the leaflet

to the point that the valve does not remain closed during systole. Blood then regurgitates

from the left ventricle back into the left atrium. About 15% of patients who develop murmurs

eventually experience heart enlargement, atrial fibrillation, pulmonary hypertension, or heart

failure (Fuster, Walsh, Harrington, et al., 2011). There is usually a gross redundancy of the

mitral valve leaflets which fails coaptation of the leaflets during systole, leading to mitral

insufficiency. Over time the patient develops mitral annual dilatation, resulting in further

worsening of the mitral insufficiency. Fortunately, most patients have minor derangements in

the leaflets and are asymptomatic.

The overall prognosis for MVP is benign. Most asymptomatic individuals are not

aware that they have MVP and do not require treatment. Complications associated with MVP

include infective endocarditis, mitral valve regurgitation, arrhythmia (atrial fibrillation),

transient ischemic event or systemic embolism. The major predictor of mortality in MVP is

the degree of mitral valve regurgitation and ejection fraction.

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