From the Guidelines
Yes, someone with mitral valve prolapse can develop aortic regurgitation, as these conditions can coexist due to shared underlying causes or age-related degenerative changes. Mitral valve prolapse (MVP) and aortic regurgitation are typically separate entities affecting different heart valves, but they can occur together in the same person 1. The presence of one valve problem may increase hemodynamic stress on other valves over time, potentially leading to the development of additional valve issues.
Key Considerations
- MVP affects the mitral valve between the left atrium and ventricle, causing it to bulge back into the atrium during contraction.
- Aortic regurgitation involves the aortic valve between the left ventricle and aorta, allowing blood to leak backward into the ventricle.
- Underlying connective tissue disorders like Marfan syndrome or Ehlers-Danlos syndrome can affect multiple heart valves, increasing the risk of coexisting valve conditions 1.
- Age-related degenerative changes can also lead to both conditions developing independently in the same person.
Management and Treatment
- Patients with MVP should receive regular cardiac evaluations to monitor for the development of additional valve issues, including aortic regurgitation, especially if they have underlying connective tissue disorders or other risk factors for valve disease 1.
- If aortic regurgitation requiring surgery is associated with severe mitral regurgitation, then both conditions should be operated on, with the type of surgery depending on the chances of successful repair and the need for anticoagulants 1.
- Concurrent aortic valve replacement is more frequently considered when mitral surgery is prosthetic valve replacement than when it is mitral valve repair, and the decision to perform concurrent mitral valve surgery should be individualized based on the patient's clinical condition and the likelihood of successful repair 1.
From the Research
Mitral Valve Prolapse and Aortic Regurgitation
- Mitral valve prolapse (MVP) is a common valve pathology that can lead to various complications, including mitral regurgitation, endocarditis, sudden death, and stroke 2.
- The relationship between MVP and aortic regurgitation is not directly addressed in the provided studies, suggesting that these may be two separate entities.
- However, a study on Marfan syndrome, a genetic disorder that can affect the heart, found that patients with MVP were more likely to undergo aortic root replacement and experience a type B aortic dissection, which can lead to aortic regurgitation 3.
Complications of Mitral Valve Prolapse
- MVP can lead to serious complications, including infective endocarditis, sudden cardiac death, and severe mitral regurgitation 4.
- Patients with MVP may exhibit early cardiac chamber remodeling, including left ventricle and left atrium remodeling, even with less than moderate mitral regurgitation 5.
- The presence of MVP can also be associated with other cardiac and noncardiac complications, particularly in patients with genetic syndromes such as Marfan syndrome 6, 3.
Management of Mitral Valve Prolapse
- The management of MVP depends on the severity of the condition and the presence of symptoms or complications 2, 4.
- Surgical correction of MVP is curative, but it is typically reserved for severe cases with irreversible complications 6.
- Earlier surgical intervention may be warranted to lower cardiovascular risk in patients with MVP, particularly those with significant valvular regurgitation or other high-risk features 6, 3.