Treatment Overview

Being told that a heart valve is not closing perfectly can be unsettling. For many people, mitral valve prolapse (MVP) is a lifelong condition that causes no symptoms and requires no intervention. However, for others, it brings noticeable and sometimes frightening sensations, such as a racing heart, palpitations, dizziness, or fatigue. These symptoms can strike unexpectedly, causing anxiety and disrupting daily focus. While the condition is generally not life-threatening, managing these symptoms is crucial for maintaining a sense of normalcy and well-being.

Treatment is essential when symptoms interfere with daily life or if the valve issue leads to complications like significant blood leakage (regurgitation) or irregular heart rhythms. The primary goals are to relieve discomfort, regulate the heart rate, and prevent long-term strain on the heart muscle. Because MVP ranges from mild cases with no symptoms to severe cases requiring intervention, treatment plans are highly personalized. Doctors tailor medication choices based on the presence of arrhythmias, the degree of leakage, and the patient’s overall heart health (American Heart Association, 2024).

Overview of treatment options for Mitral Valve Prolapse

For the vast majority of patients, the treatment approach is “watchful waiting,” involving regular check-ups to monitor the valve. However, when symptoms like chest pain, anxiety, or palpitations occur, pharmacological treatment is the first line of defense.

The medical management of MVP focuses on stabilizing the heart’s rhythm and reducing the workload on the heart. While surgery is the standard solution for severe mitral valve regurgitation (where the valve leaks significantly), medications are used to manage symptoms and delay or prevent the need for surgical repair. In cases where MVP is associated with dysautonomia (an imbalance in the autonomic nervous system), medications help regulate the body’s response to adrenaline.

Medications used for Mitral Valve Prolapse

Beta-blockers are the most commonly prescribed medications for symptomatic mitral valve prolapse. Drugs such as metoprolol, atenolol, or bisoprolol are frequently used. Clinical experience suggests that these medications are highly effective at controlling palpitations and the accompanying chest discomfort that many patients experience. They are particularly helpful for those whose symptoms are triggered by exercise or stress.

For patients who cannot tolerate beta-blockers or who have specific heart rhythm issues, calcium channel blockers may be prescribed. Medications like verapamil or diltiazem serve as alternatives to help control the heart rate.

If the valve prolapse leads to significant regurgitation and subsequent fluid retention (mild heart failure symptoms), doctors may prescribe diuretics (water pills) such as furosemide. These help remove excess fluid from the body. Additionally, if the condition is associated with atrial fibrillation (an irregular heart rhythm), blood thinners (anticoagulants) like warfarin or direct oral anticoagulants may be necessary to prevent blood clots. While antibiotics were once routinely prescribed before dental procedures, current guidelines reserve them only for patients with specific high-risk features or prior heart infections (Mayo Clinic, 2022).

How these medications work

Beta-blockers treat Mitral Valve Prolapse (MVP) symptoms by blocking epinephrine (adrenaline) effects on the heart. This action slows heart rate and reduces contraction force, “calming” the heart and easing palpitations caused by the heart’s oversensitivity to adrenaline.

Calcium channel blockers relax blood vessels and modify the heart’s electrical conduction to slow a rapid heart rate. Diuretics reduce blood volume by increasing salt and water expulsion via the kidneys, lowering blood pressure and strain on a heart with a leaky valve.

Side effects and safety considerations

Beta-blockers commonly cause fatigue, cold extremities, or dizziness from low blood pressure; some experience sluggishness or vivid dreams. Calcium channel blockers may cause constipation or ankle swelling.

Diuretics require monitoring of kidney function and electrolytes due to potential potassium depletion. Anticoagulants pose a bleeding risk, necessitating injury avoidance. Regular blood pressure monitoring is vital when starting these heart medications. Patients should seek immediate care for persistent shortness of breath, fainting, or signs of stroke (e.g., sudden weakness, speech difficulty) (National Heart, Lung, and Blood Institute, 2023).

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

  1. American Heart Association. https://www.heart.org
  2. Mayo Clinic. https://www.mayoclinic.org
  3. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov
  4. MedlinePlus. https://medlineplus.gov

Medications for Mitral Valve Prolapse

These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Mitral Valve Prolapse.

Found 1 Approved Drug for Mitral Valve Prolapse

Erythrocin Lactobionate

Generic Name
Lactobionate

Erythrocin Lactobionate

Generic Name
Lactobionate
Form: Injection
Method of administration: Intravenous
FDA approval date: May 25, 2005
Classification: Macrolide
Erythrocin Lactobionate-IV (erythromycin lactobionate for injection, USP) is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the diseases listed below when oral administration is not possible or when the severity of the infection requires immediate high serum levels of erythromycin. Intravenous therapy should be replaced by oral administration at the appropriate time. Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes (Group A beta-hemolytic streptococci); Streptococcus pneumoniae (Diplococcus pneumoniae); Haemophilus influenzae (when used concomitantly with adequate doses of sulfonamides, since many strains of H. influenzae are not susceptible to the erythromycin concentrations ordinarily achieved). (See appropriate sulfonamide labeling for prescribing information). Lower respiratory tract infections of mild to moderate severity caused by Streptococcus pyogenes (Group A beta-hemolytic streptococci); Streptococcus pneumoniae (Diplococcus pneumoniae). Respiratory tract infections due to Mycoplasma pneumoniae. Skin and skin structure infections of mild to moderate severity caused by Streptococcus pyogenes and Staphylococcus aureus (resistant staphylococci may emerge during treatment). Diphtheria: As an adjunct to antitoxin infections due to Corynebacterium diphtheriae to prevent establishment of carriers and to eradicate the organism in carriers. Erythrasma: In the treatment of infections due to Corynebacterium minutissimum. Acute pelvic inflammatory disease caused by Neisseria gonorrhoeae : Erythrocin Lactobionate-IV (erythromycin lactobionate for injection, USP) followed by erythromycin stearate or erythromycin base orally, as an alternative drug in treatment of acute pelvic inflammatory disease caused by N. gonorrhoeae in female patients with a history of sensitivity to penicillin. Before treatment of gonorrhea, patients who are suspected of also having syphilis should have a microscopic examination for T. pallidum (by immunofluorescence or darkfield) before receiving erythromycin and monthly serologic tests for a minimum of 4 months thereafter. Legionnaires' Disease caused by Legionella pneumophila. Although no controlled clinical efficacy studies have been conducted, in vitro and limited preliminary clinical data suggest that erythromycin may be effective in treating Legionnaires' Disease. Prevention of Initial Attacks of Rheumatic Fever Penicillin is considered by the American Heart Association to be the drug of choice in the prevention of initial attacks of rheumatic fever (treatment of Group A beta-hemolytic streptococcal infections of the upper respiratory tract e.g., tonsillitis, or pharyngitis). 1 Erythromycin is indicated for the treatment of penicillin-allergic patients. The therapeutic dose should be administered for ten days. Prevention of Recurrent Attacks of Rheumatic Fever Penicillin or sulfonamides are considered by the American Heart Association to be the drugs of choice in the prevention of recurrent attacks of rheumatic fever. In patients who are allergic to penicillin and sulfonamides, oral erythromycin is recommended by the American Heart Association in the long-term prophylaxis of streptococcal pharyngitis (for the prevention of recurrent attacks of rheumatic fever). 1 Prevention of Bacterial Endocarditis Although no controlled clinical efficacy trials have been conducted, oral erythromycin has been recommended by the American Heart Association for prevention of bacterial endocarditis in penicillin-allergic patients with prosthetic cardiac valves, most congenital cardiac malformations, surgically constructed systemic pulmonary shunts, rheumatic or other acquired valvular dysfunction, idiopathic hypertrophic subaortic stenosis (IHSS), previous history of bacterial endocarditis and mitral valve prolapse with insufficiency when they undergo dental procedures and surgical procedures of the upper respiratory tract. 2 To reduce the development of drug-resistant bacteria and maintain the effectiveness of erythromycin and other antibacterial drugs, erythromycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
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