Mitral Valve Prolapse and the Benefits of Exercise

Aerobic exercise remains key to managing the disease

It is estimated that two to four percent of the population has some degree of mitral valve prolapse (MVP). You can safely exercise if you have this condition, and it is beneficial for you to get regular exercise. You can talk to your doctor if you want specific guidance about how much and what types of exercises you should start with.

The mitral valve is located in the heart's left ventricle between the upper and lower chambers. This valve opens to allow blood to move from the upper atrium and the lower ventricle on the left side of the heart, and then closes to prevent the backflow of blood.

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Normally, heart valves are fairly rigid, and they open and close completely with regularity. A prolapsed 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 and may permit a tiny amount of blood to leak through, producing a heart murmur.

A large mitral valve prolapse can allow blood to seep back into the heart’s top chamber. This is called mitral regurgitation or a "leaky valve."

Mitral valve prolapse is generally not considered to be life-threatening or progressive. It is one of the more benign causes of a heart murmur. It is likely that there is a genetic component to MVP since it can run in families.

What Are the Symptoms and Complications of MVP?

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

The main concern for those living with MVP is that long-term complications can arise if the condition is not properly treated.

Endocarditis

The risk of developing endocarditis, a heart infection, is a rare but potential complication of having a leaky heart valve.

Mitral Regurgitation

Mitral regurgitation is the backflow of blood from the ventricle to the atrium. Mitral regurgitation can lead to enlargement of the cardiac chamber, weakening of the heart muscle, and, in some cases, heart failure.

Clinically significant mitral regurgitation due to mitral valve prolapse is relatively rare, affecting only around 5 percent of those with MVP. People who have had a previous heart attack or prolonged exposure to the drug Ergomar (ergotamine) are at the highest risk.

Treatment

Treatment for MVP varies depending upon the extent of the prolapse. Your symptoms and staging can help your doctor decide whether you need treatment.

How to Exercise When You Have MVP

It's important to discuss your individual symptoms with your physician before starting an exercise plan. The heart is a muscle that gets stronger with exercise. Aerobic exercise strengthens the heart and makes it more efficient. This type of exercise is generally recommended for people who have MVP.

Aerobic exercise includes walking, jogging, swimming, or cycling. A moderate pace for 30 minutes at a time is a good way to get started. You should monitor your heart rate and slow down if you feel your heart racing or if you start to feel dizzy or lightheaded.

People 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 mitral valve prolapse.

Severe cases may require the input of a cardiologist to ensure that exercise doesn't inadvertently promote mitral regurgitation. In some cases, exercise can place undue stress on the mitral valve, causing more harm than good.

Your cardiologist may ask you to undergo an exercise tolerance test during which you would have an electrocardiogram (ECG) while on a treadmill or stationary bike. The results of this test can determine how much exercise you can safely perform without compromising your mitral valve.

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  1. Bertrand PB, Sdhwammentthal E, Levine RA, et al. Exercise Dynamics in Secondary Mitral Regurgitation: Pathophysiology and Therapeutic Implications. Circulation. 2017 Jan 17;135(3):297-314. doi:10.1161/CIRCULATIONAHA.116.025260


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