From the Guidelines
Barlow syndrome, also known as mitral valve prolapse, often presents with symptoms such as heart palpitations, chest pain, fatigue, shortness of breath, dizziness, and anxiety, which can be managed with reassurance, beta blockers, and lifestyle modifications, as recommended by the American College of Cardiology/American Heart Association guidelines 1.
Symptoms of Barlow Syndrome
The symptoms of Barlow syndrome can vary widely among individuals, but common complaints include:
- Heart palpitations, which may feel like a racing or irregular heartbeat, particularly during physical exertion or emotional stress
- Chest pain, typically manifesting as a sharp, stabbing pain that comes and goes, rather than the crushing pressure associated with heart attacks
- Fatigue and shortness of breath, which may occur during physical activity as the heart works harder to compensate for the valve abnormality
- Dizziness or lightheadedness, due to changes in blood pressure or heart rhythm
- Anxiety, which can both trigger and result from these physical symptoms
Diagnosis and Management
The primary diagnostic evaluation of Barlow syndrome is the physical examination, which may reveal a characteristic clicking sound followed by a heart murmur 1. Two-dimensional and Doppler echocardiography is the most useful noninvasive test for defining mitral valve prolapse, and can help identify valve prolapse, leaflet thickness, and the presence or absence of mitral regurgitation 1. Reassurance and lifestyle modifications, such as regular exercise and avoidance of stimulants like caffeine and alcohol, are major components of the management of patients with Barlow syndrome, as recommended by the American College of Cardiology/American Heart Association guidelines 1. In some cases, beta blockers may be prescribed to manage symptoms such as palpitations and chest pain, and antibiotic prophylaxis may be recommended to prevent endocarditis during procedures associated with bacteremia 1.
Important Considerations
It's essential to note that many people with Barlow syndrome remain asymptomatic, and the condition is often discovered incidentally during physical examinations. The American College of Cardiology/American Heart Association guidelines recommend a normal lifestyle and regular exercise for most patients with Barlow syndrome, especially those who are asymptomatic 1. However, patients with high-risk echocardiographic characteristics or a history of transient ischemic attacks may require more intensive management, including daily aspirin therapy or anticoagulation with warfarin 1.
From the Research
Barlow Syndrome Symptoms
- The symptoms of Barlow syndrome can vary widely, ranging from mild to severe, and may include chest pain, shortness of breath, fatigue, lightheadedness, syncope, palpitations, anxiety, and panic attacks 2
- Some patients with Barlow syndrome may be asymptomatic, while others may experience significant complications, such as mitral regurgitation, endocarditis, sudden death, and stroke 3
- The syndrome can also cause hemodynamic alterations that reduce quality of life and modify prognosis 4
- Patients with Barlow syndrome may experience a range of symptoms due to the prolapse of the mitral valve, including mitral valve billow and prolapse 5
Clinical Features
- Barlow syndrome is characterized by the presence of mitral valve prolapse and a wide range of signs and symptoms 4
- The diagnosis of Barlow syndrome requires clear and unambiguous criteria, which were identified through penetrative clinical research 5
- The differentiation of Barlow syndrome from other conditions with similar symptoms requires a high degree of specificity 5
Complications
- Barlow syndrome can lead to significant complications, such as mitral regurgitation, endocarditis, sudden death, and stroke 3
- The syndrome can also cause hemodynamic alterations that reduce quality of life and modify prognosis 4
- Patients with Barlow syndrome may experience a range of symptoms due to the prolapse of the mitral valve, including mitral valve billow and prolapse 5