Migraine Quiz

Mitral Valve Prolapse

 

What is Mitral Valve Prolapse?

Mitral valve prolapse occurs when the leaflets of the valve between the left atrium of the heart and the left ventricle are too large, or the strings (chorda tendinaei) that connect them to the heart wall are too long. This causes them to close unevenly and bulge back into the left atrium (the upper chamber of the heart). In most cases, the valve still functions as it should. In a few cases, it may leak blood. This is called mitral regurgitation.

Mitral valve prolapse affects between 3%-10% of the population. About 60% of individuals with MVP have no symptoms. Mitral valve prolapse is also called click-murmur syndrome, Barlow's syndrome, balloon mitral valve, and floppy valve syndrome.

Mitral valve prolapse, or MVP, is more common in people who have connective tissue disorders such as Marfan's Syndrome or Ehlers-Danlos Syndrome, in people with Graves Disease, or in polycystic kidney disease. About 40% of people who have MVP also have a condition known as dysatunomia, a disorder of the autonomic nervous system. Dysautonomia can causea variety of conditions that affect heart rate, blood pressure, and other bodily functions.

Symptoms of MVP

Symptoms of MVP can be brought out by stresses on the body like pregnancy, a viral illness, or major life stresses. MVP symptoms include chest pain, dizziness, palpitations (especially when lying on the left side), fatigue, shortness of breath with exertion or when lying flat, lightheadedness, and chronic low energy. In the infrequent, more severe cases of MVP with mitral regurgitation, symptoms of congestive heart failure can occur, with swollen legs and arrhythmia. Only in the most severe cases is valve replacement surgery necessary. Medical treatment is available for arrythmia. The majority of people with MVP do not require any treatment.

Mitral Valve Prolapse and Migraine

A 1984 study of 100 migraine patients and 100 controls who all underwent echocardiography and clinical examination found that 11% of the control group and 25% of the migraine group had evidence of mitral valve prolapse.A larger, older study found that 27.8% of migraineurs had MVP. A study of only migraine with aura patients found a 15% rate of definite MVP, and 16% of probable MVP.

Why is there a connection? This is not known for certain. One theory is that blood platelets are damaged by the floppy valve leaflets, releasing serotonin from within the platelet. Serotonin is one of the chemicals in the body that has been implicated in the cause of migraine.

References:

1. Spence JD, Wong DG, Melendez LJ, et al. Increased prevalence of mitral valve
prolapse in patients with migraine. Can Med Assoc J 1984;131:1457–60.

2. Litman GI, Friedman HM. Migraine and the mitral valve prolapse syndrome. Am
Heart J 1978;96:610–4.

3. Amat G, Jean Louis P, Loisy C, et al. Migraine and the mitral valve prolapse
syndrome. Adv Neurol 1982;33:27–9.

by Christina Peterson, M.D.

updated June 12, 2011