Mitral Valve Prolapse and Exercise

The mitral valve is located in the heart's left ventricle between the upper and lower chambers. This valve has a right and left section that open to allow blood to move from the upper atrium and the lower ventricle on the left side of the heart, and then close to prevent the backflow of blood.

A normal valve is fairly rigid and opens and closes completely with regularity. The term prolapse means that the valve is loose and a little floppy so that it doesn't shut as firmly as it should. It may close with a faint click or may permit a tiny amount of blood to leak through, producing a heart murmur. A large prolapse can allow blood to seep back into the heart’s top chamber. This is called mitral regurgitation.

It is estimated that two to four percent of the population has a mitral valve prolapse of some degree. It is also likely that there is a genetic component to MVP since it seems to run in families.

Many people live their whole lives without symptoms. Those who do have symptoms may experience heart palpitations, chest pain, fainting, shortness of breath, lessened stamina, or fatigue with periods of weakness.

The two main concerns for those with MVP are the long-term effects of mitral regurgitation and the potential development of a heart infection called endocarditis.

• Mitral Regurgitation: The backflow of blood from the ventricle to the atrium (regurgitation) can lead to enlargement of the cardiac chambers and weakening of the heart muscle. This can potentially lead to heart failure. This is relatively rare, however, and only about 5 percent of those with MVP have a large enough regurgitation to cause any problem.
• Endocarditis: The risk of developing a heart infection called endocarditis is a rare but potential occurrence anytime there is a leaky heart value. To decrease the risk of this infection, doctors prescribe antibiotics to patients with MVP before any procedure that is likely to introduce bacteria into the bloodstream. For example, most people with diagnosed MVP will take antibiotics before dental work.

The heart is a muscle and, like any muscle, it gets stronger with exercise. Aerobic exercise strengthens the heart and makes it more efficient and is generally recommended for those with MVP. Aerobic exercise including walking, jogging, swimming, or cycling, at a moderate pace for 30 minutes at a time is the safest way to begin exercise. A person with MVP should monitor their heart rate and other symptoms and slow down if they feel their heart racing or lightheaded or faint.

Mitral valve prolapse is generally not considered to be a life-threatening or a progressive condition. MVP may be the most benign of the various types of heart murmurs. There are cases, however, where MVP poses significant health problems and in these cases, valve replacement would be considered.

The short answer to this question is that no one really knows, but it appears that if there is any risk of sudden death, it is very, very small. Research that links the two is based upon autopsy findings that showed that about 10 percent of people who died suddenly had MVP.

According to heart disease expert, Richard Fogoros, M.D., "the vast majority of patients with MVP have never been shown to have any higher risk of sudden death than the general population."

Those who experience chest pains, heart palpitations or other significant symptoms of MVP are sometimes given beta-blockers to slow the heart rate during exercise. Rarely is someone discouraged from exercise because of a mitral valve prolapse. As a matter of fact, aerobic exercise is one of the things recommended for individuals who have such a prolapse. Treatment for MVP varies depending upon the extent of the prolapse, so it's important to discuss your individual symptoms with your physician.

If you have been told you have MVP, you may need to make sure you have received a correct diagnosis. According to Dr. Fogoros, MVP is overdiagnosed. He offers some advice for those diagnosed with MVP regarding getting a correct diagnosis.

Mitral valve prolapse can only be diagnosed by a physician. As always, seek medical advice before beginning any new exercise program.