Most people with mitral valve prolapse, particularly people without symptoms, don't require treatment.
If you have mitral valve regurgitation but don't have symptoms, your doctor may suggest you return regularly for follow-up examinations to monitor your condition, depending on the severity of your condition.
However, if you have symptoms and if a significant amount of blood is leaking through the mitral valve, your doctor may recommend medications or surgery.
Medications can treat mitral valve prolapse-related heart rhythm abnormalities or other complications. Some medications you might be prescribed include:
- Beta blockers. These drugs help prevent irregular heartbeats by making your heart beat more slowly and with less force, which reduces your blood pressure. Beta blockers also help blood vessels relax and open up to improve blood flow.
- Water pills (diuretics). Your doctor may prescribe diuretics to drain fluid from your lungs.
- Heart rhythm medications. If you have an arrhythmia, your doctor may prescribe a medication to treat it, such as propafenone (Rythmol SR), sotalol (Betapace, Sorine, Sotylize), flecainide and amiodarone (Pacerone). The medications help control your heart rhythm by normalizing electrical signals in heart tissue.
- Aspirin. If you have mitral valve prolapse and a history of strokes, your doctor might prescribe aspirin to reduce the risk of blood clots.
Blood thinners. If you have atrial fibrillation, a history of heart failure or a history of strokes, your doctor may suggest a blood thinner to prevent your blood from clotting. They include warfarin (Coumadin, Jantoven), heparin, dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa).
Blood thinners can have dangerous side effects, however, and must be taken exactly as prescribed.
Though most people with mitral valve prolapse don't need surgery, your doctor may suggest surgical treatment if you have severe mitral valve regurgitation, whether you have symptoms or not.
Severe mitral valve regurgitation can eventually cause heart failure, preventing your heart from effectively pumping blood. If regurgitation goes on too long, your heart may be too weak for surgery.
Surgery involves repairing or replacing the mitral valve. Valve repair and replacement may be performed using open-heart surgery or minimally invasive surgery. Minimally invasive surgery involves smaller incisions and may have less blood loss and a quicker recovery time.
For most people, mitral valve repair is the preferred surgical treatment. During surgery, your surgeon will modify your own valve to stop backward blood flow by reconnecting the flappy valve tissue or by removing excess tissue. Your surgeon may also reinforce the ring around the heart valve to prevent blood from leaking backward.
If mitral valve repair isn't possible, your surgeon may replace it with an artificial valve that is man-made (mechanical) or is made from human tissue or taken from cows or pigs.
Mechanical valves can last a lifetime but you'll need to take a blood thinner to prevent blood clots from forming on the valve. If a blood clot broke free, it could cause a stroke. You generally won't need to take a blood thinner with a valve made from human or animal tissue, but those valves only last about 10 years.
Transcatheter valve therapy
If you have severe mitral regurgitation and can't have surgery, your doctor may recommend a less invasive approach called transcatheter valve therapy. The new technique allows your doctor to repair a valve by implanting a device using a tube (catheter) inserted in a blood vessel in your groin and guided to your heart.
Antibiotics seldom recommended
Doctors used to recommend that some people with mitral valve prolapse take antibiotics before certain dental or medical procedures. However, the American Heart Association has said antibiotics are no longer necessary in most cases for someone with mitral valve regurgitation or mitral valve prolapse.
If you've been told to take antibiotics before any procedures in the past, check with your doctor about whether it's still necessary.