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Mitral valve prolapse

Last reviewed: 2 Apr 2025
Last updated: 27 Sep 2024

Summary

Definition

History and exam

Key diagnostic factors

  • midsystolic click
  • late-systolic murmur
Full details

Other diagnostic factors

  • palpitations
Full details

Risk factors

  • family history
  • slim body type
  • connective tissue disorders
  • mitral annular disjunction (MAD)
Full details

Diagnostic tests

1st tests to order

  • echocardiogram
Full details

Tests to consider

  • Holter or event monitor
  • cardiac MRI
Full details

Treatment algorithm

ACUTE

asymptomatic

symptomatic

Contributors

Authors

Sheila Klassen, MD

Assistant Professor of Medicine

Harvard Medical School

Associate Director of Cardiovascular Integration

Center for Integration Science

Brigham and Women's Hospital

Boston

MA

Disclosures

SK declares that he has no competing interests.

Acknowledgements

Dr Sheila Klassen would like to gratefully acknowledge Dr Brian Griffin, Dr Shaberio Lo Presti, Dr Carmel Halley, and Dr Serge Harb, previous contributors to this topic.

Disclosures

BG, SLP, CH, and SH declared that they had no competing interests.

Peer reviewers

John Dent, MD

Associate Professor of Internal Medicine

Director of Stress Testing Laboratory and Echocardiography

University of Virginia Health System

Cardiovascular Fellowship Program

Charlottesville

VA

Disclosures

JD declares that he has no competing interests.

Prakash Punjabi, MBBS

Honorary Clinical Senior Lecturer

National Heart and Lung Institute

Imperial College London

London

UK

Disclosures

PP declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021 Feb 2;143(5):e72-e227.Full text  Abstract

Delgado V, Ajmone Marsan N, de Waha S, et al. 2023 ESC guidelines for the management of endocarditis. Eur Heart J. 2023 Oct 14;44(39):3948-4042.Full text

Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2021 Aug 28:ehab395.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Mitral valve prolapse images
  • Differentials

    • Aortic valve disease
    • Pulmonic valve disease
    • Atrial myxoma
    More Differentials
  • Guidelines

    • 2023 ESC guidelines for the management of endocarditis
    • 2021 ESC/EACTS guidelines for the management of valvular heart disease
    More Guidelines
  • Patient information

    Mitral valve prolapse

    More Patient information
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