Mitral Valve Prolapse Ain’t What It Used To Be

The prevalence of Mitral Valve Prolapse (MVP) has been estimated to range from 5-35 percent of the population, with the predominance occurring in women. Furthermore, people with MVP have been told that they are at greater risk for a myriad of problems including stroke, atrial fibrillation, heart failure, mitral valve regurgitation requiring surgery, and infections from dental procedures, in particular. Now a study coming out of the well-known, long-term Framingham Heart Study challenges many of these notions.* Researchers in this study examined 1845 women and 1646 men for MVP using more precise methods – three dimensional imaging rather than two dimensional imaging – used in previous studies. Their results were striking. Only 47 subjects had classic MVP and 37 subjects had non-classic MVP (this adds up to 84 subjects, or 2.4 percent of those in the study). Fifty out of the 84 subjects diagnosed with MVP were women and thirty-four were men. Distribution by age was equal in all decades of life from the twenties to the eighties. When it came to being vulnerable to the various risks such as stroke, etc., the MVP group had no greater frequency of problems than the other 3407 subjects (without MVP) in the study. The study concluded that the numbers of persons with MVP was lower than previously reported and that the sequelae commonly associated with this diagnosis was also low. Knowing this does not change the need for patients with MVP to premedicate with antibiotics when receiving dental treatment, and the current American Heart Association standards still apply. What this study does imply is that further testing may reverse a previous diagnosis of MVP that will eliminate exposure to antibiotics and undue concerns.

*Freed, L.A., et all: Prevalence and clinical outcome of mitral-valve prolapse. New Eng J Med 341: 1-7, 1999.