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PubMed This is a summary of 23 peer-reviewed journal articles Updated
Cardiology

Building a Foundation: What Is Mitral Valve Prolapse?

At a Glance

Mitral valve prolapse happens when one or both mitral valve flaps bulge backward into the heart’s upper chamber during a heartbeat. It is often mild and stable, but an echocardiogram checks for leakage and helps doctors decide whether family history or other findings need closer monitoring.

Learning you have a heart valve condition can be unsettling, but it is important to start with a clear perspective: for the vast majority of people, Mitral Valve Prolapse (MVP) is a benign structural variation rather than a dangerous disease [1][2].

Modern research shows that MVP is remarkably common, affecting approximately 1.35% to 2.2% of the general population [3][4]. Most people with uncomplicated MVP live full, active lives with a life expectancy similar to those without the condition [1]. Understanding the biology of your heart can help transform a scary diagnosis into a manageable part of your health history.

The Biology of the “Click”

The mitral valve acts as a one-way gate between the two left chambers of your heart. It consists of two flaps, called leaflets, that should seal shut perfectly when the heart pumps.

In MVP, these leaflets are slightly longer or more flexible than usual. When the heart contracts, they don’t just seal; they bulge or “prolapse” backward into the upper chamber (the left atrium).

  • The 2mm Rule: To be officially diagnosed with MVP today, an echocardiogram must show at least one leaflet displacing by at least 2 millimeters beyond the annular plane in the parasternal long-axis view [5][6].
  • The Sound: Doctors often hear a “click” through a stethoscope, which is the sound of the leaflets and their supporting chords suddenly tensing as they bulge during the heartbeat, much like a sail catching the wind [7].

In many cases, this prolapse is “isolated,” meaning the valve still seals tightly despite the bulge. This is why many people with MVP have no symptoms and only discover the condition during a routine physical or an echocardiogram (an ultrasound of the heart) [7].

Understanding the Different Types

If you look at your medical report, you might see terms describing how the valve tissue looks. Doctors generally describe the valve’s physical appearance along a spectrum, which includes two main phenotypes:

  1. Fibro-elastic Deficiency (FED): This is often seen in older adults. The valve tissue is relatively thin and may be missing some of its structural proteins [8]. Over time, one of the thin “chords” (the tiny “parachute strings” that hold the valve in place) may stretch or break, causing the prolapse [9].
  2. Myxomatous Degeneration (Barlow Disease): This is typically seen in younger patients. The valve leaflets are thickened, “fleshy,” and redundant [10]. In this type, the biological makeup of the valve has extra connective tissue, making the leaflets larger and more prone to bulging [11][8].

Is It in the Genes?

It is common for MVP to run in families. Research suggests that between 20% and 35% of people with MVP have a heritable component [12][13].

Most familial MVP is “non-syndromic,” meaning it affects only the heart valve and nothing else. Scientists have identified specific susceptibility genes, such as DCHS1, DZIP1, and TNS1, that are associated with how the valve develops [14][15][16].

In a small number of cases, MVP is part of a broader connective tissue syndrome that affects other parts of the body:

  • Marfan Syndrome: Caused by the FBN1 gene, this condition often involves very tall stature and long limbs; many people with Marfan syndrome also have MVP [17][18].
  • Loeys-Dietz Syndrome: Associated with genes like TGFBR1 or SMAD3, this can affect the heart valves and the aorta (the body’s main artery) [19][20].
  • FLNA-related Associations: A rare form that can be more severe in men and sometimes affects other heart valves [21].

Knowing your family history can help your doctor decide if you need extra monitoring. Routine echocardiographic screening for children or siblings is not automatically necessary for every person with MVP, but it is highly relevant if you have a strong family history of early valve disease, sudden cardiac death, or features of a connective-tissue syndrome.

A Focus on Stability

The most important takeaway is that for the majority of people, MVP does not progress rapidly or require surgery [4]. While you may need periodic follow-ups to ensure the valve remains stable, the diagnosis itself is often just a “footnote” in a person’s health story. Modern imaging allows doctors to monitor your heart, ensuring that if anything does change over the decades, it can be managed long before it becomes a problem [22][23].

Common questions in this guide

What is mitral valve prolapse, and is it dangerous?
Mitral valve prolapse means one or both flaps of the mitral valve bulge backward into the left upper heart chamber when the heart contracts. In many people, the valve still closes tightly, causes no symptoms, and remains a stable finding rather than a dangerous disease.
How is mitral valve prolapse confirmed on an echocardiogram?
An echocardiogram is an ultrasound of the heart. Current diagnostic criteria generally require at least one valve leaflet to move 2 millimeters or more beyond the supporting ring of the valve in a specified ultrasound view; the test can also show whether blood leaks backward through the valve.
What is the difference between fibro-elastic deficiency and Barlow disease?
Fibro-elastic deficiency usually involves thinner valve tissue and is more often seen in older adults, sometimes after a supporting chord stretches or breaks. Barlow disease, also called myxomatous degeneration, usually involves thick, redundant leaflets and is more often seen in younger patients.
Can mitral valve prolapse be inherited, and should my family be tested?
Mitral valve prolapse can run in families, and about one-fifth to one-third of people with it may have a heritable component. Routine echocardiograms are not automatically needed for every child or sibling, but a strong history of early valve disease, sudden cardiac death, or connective-tissue features may prompt genetic counseling or targeted screening.
What does mitral regurgitation mean if I have mitral valve prolapse?
Mitral regurgitation means that some blood leaks backward through the mitral valve when the heart contracts instead of moving fully forward. An echocardiogram can estimate how much leakage is present, and your cardiologist can explain what its severity means for monitoring.
Will mitral valve prolapse get worse or require surgery?
For most people with uncomplicated mitral valve prolapse, the condition does not progress rapidly and does not require surgery. Periodic echocardiograms allow doctors to monitor the valve over time, while leakage or other high-risk findings may call for closer follow-up.

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References

References (23)
  1. 1

    Isolated Flailed P3 Scallop of the Mitral Valve Leaflet in the Setting of Newly Diagnosed Heart Failure With Preserved Ejection Fraction.

    Salas Noain J, Mizrahi E, Zheng S, Minupuri A

    Cureus 2020; (12(8)):e9919 doi:10.7759/cureus.9919.

    PMID: 32968580
  2. 2

    Cardiovascular magnetic resonance in patients with mitral valve prolapse.

    Figliozzi S, Di Maio S, Georgiopoulos G, et al.

    Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 2025; (27(1)):101137 doi:10.1016/j.jocmr.2024.101137.

    PMID: 39725235
  3. 3

    Prevalence, progression, and clinical outcomes of mitral valve prolapse: a systematic review and meta-analysis.

    Melamed T, Badiani S, Harlow S, et al.

    European heart journal. Quality of care & clinical outcomes 2025; (11(5)):631-641 doi:10.1093/ehjqcco/qcaf016.

    PMID: 40156585
  4. 4

    Echocardiographic Assessment of Mitral Valve Prolapse Prevalence before and after the Year 1999: A Systematic Review.

    Sonaglioni A, Nicolosi GL, Bruno A, et al.

    Journal of clinical medicine 2024; (13(20)) doi:10.3390/jcm13206160.

    PMID: 39458110
  5. 5

    Prevalence and characteristics of mitral valve prolapse in military young adults in Taiwan of the CHIEF Heart Study.

    Liu PY, Tsai KZ, Lin YP, et al.

    Scientific reports 2021; (11(1)):2719 doi:10.1038/s41598-021-81648-z.

    PMID: 33526804
  6. 6

    The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse.

    Vermes E, Altes A, Iacuzio L, et al.

    Frontiers in cardiovascular medicine 2023; (10()):1093060 doi:10.3389/fcvm.2023.1093060.

    PMID: 36937904
  7. 7

    Mitral Valve Prolapse-The Role of Cardiac Imaging Modalities.

    Adabifirouzjaei F, Hsiao A, DeMaria AN

    Structural heart : the journal of the Heart Team 2022; (6(2)):100024 doi:10.1016/j.shj.2022.100024.

    PMID: 37273735
  8. 8

    Explainable machine learning and unsupervised anatomical phenotyping of mitral valve prolapse in patients with severe mitral regurgitation.

    Eini P, Serpoush H, Rezayee M

    BMC cardiovascular disorders 2026; (26(1)).

    PMID: 42881371
  9. 9

    Usefulness of 3-Tesla Cardiac Magnetic Resonance to Detect Mitral Annular Disjunction in Patients With Mitral Valve Prolapse.

    Essayagh B, Iacuzio L, Civaia F, et al.

    The American journal of cardiology 2019; (124(11)):1725-1730 doi:10.1016/j.amjcard.2019.08.047.

    PMID: 31606191
  10. 10

    The Role of Transforming Growth Factor-β Signaling in Myxomatous Mitral Valve Degeneration.

    Tang Q, McNair AJ, Phadwal K, et al.

    Frontiers in cardiovascular medicine 2022; (9()):872288 doi:10.3389/fcvm.2022.872288.

    PMID: 35656405
  11. 11

    Genetics of syndromic and non-syndromic mitral valve prolapse.

    Le Tourneau T, Mérot J, Rimbert A, et al.

    Heart (British Cardiac Society) 2018; (104(12)):978-984 doi:10.1136/heartjnl-2017-312420.

    PMID: 29352010
  12. 12

    Genetic mechanisms underlying arrhythmogenic mitral valve prolapse: Current and future perspectives.

    Levy S, Sharaf Dabbagh G, Giudicessi JR, et al.

    Heart rhythm O2 2023; (4(9)):581-591 doi:10.1016/j.hroo.2023.08.003.

    PMID: 37744942
  13. 13

    Familial occurrence of mitral regurgitation in patients with mitral valve prolapse undergoing mitral valve surgery.

    Hiemstra YL, Wijngaarden ALV, Bos MW, et al.

    European journal of preventive cardiology 2020; (27(3)):272-280 doi:10.1177/2047487319874148.

    PMID: 31475862
  14. 14

    Mutations in DCHS1 cause mitral valve prolapse.

    Durst R, Sauls K, Peal DS, et al.

    Nature 2015; (525(7567)):109-13 doi:10.1038/nature14670.

    PMID: 26258302
  15. 15

    Primary cilia defects causing mitral valve prolapse.

    Toomer KA, Yu M, Fulmer D, et al.

    Science translational medicine 2019; (11(493)) doi:10.1126/scitranslmed.aax0290.

    PMID: 31118289
  16. 16

    Genetic background of mitral valve prolapse.

    Guicciardi NA, De Bonis M, Di Resta C, et al.

    Reviews in cardiovascular medicine 2022; (23(3)):96 doi:10.31083/j.rcm2303096.

    PMID: 35345263
  17. 17

    Frequency of Cardiac Valvulopathies in Patients With Marfan Syndrome: A Systematic Review and Meta-Analysis.

    Sama C, Fongwen NT, Chobufo MD, et al.

    Cureus 2024; (16(2)):e54141 doi:10.7759/cureus.54141.

    PMID: 38487153
  18. 18

    Clinical and Phenotypic Correlates of Mitral Valve Prolapse in Marfan Syndrome: The Cornell Aortic Aneurysm Registry.

    Narula N, Schwartz Y, Devereux RB, et al.

    Journal of the American Heart Association 2025; (14(10)):e040947 doi:10.1161/JAHA.125.040947.

    PMID: 40357669
  19. 19

    Clinical features and complications of Loeys-Dietz syndrome: A systematic review.

    Gouda P, Kay R, Habib M, et al.

    International journal of cardiology 2022; (362()):158-167 doi:10.1016/j.ijcard.2022.05.065.

    PMID: 35662564
  20. 20

    The Burden of Cardiac Arrhythmias in Loeys-Dietz Syndrome: Prevalence, Etiology, and Therapeutic Interventions.

    Nabi HA, Bcharah G, Bcharah H, et al.

    JACC. Advances 2025; (4(11 Pt 1)):102269 doi:10.1016/j.jacadv.2025.102269.

    PMID: 41135387
  21. 21

    New insights into mitral valve dystrophy: a Filamin-A genotype-phenotype and outcome study.

    Le Tourneau T, Le Scouarnec S, Cueff C, et al.

    European heart journal 2018; (39(15)):1269-1277 doi:10.1093/eurheartj/ehx505.

    PMID: 29020406
  22. 22

    Mitral Valve Regurgitation in the Contemporary Era: Insights Into Diagnosis, Management, and Future Directions.

    El Sabbagh A, Reddy YNV, Nishimura RA

    JACC. Cardiovascular imaging 2018; (11(4)):628-643 doi:10.1016/j.jcmg.2018.01.009.

    PMID: 29622181
  23. 23

    Acquired Gerbode Defect Diagnosed Seven Years After Surgical Mitral Valve Repair for Severe Primary Mitral Valve Regurgitation: A Case Report.

    Kazma H, Iskandar S, Hitti J, et al.

    Cureus 2025; (17(10)):e94436 doi:10.7759/cureus.94436.

    PMID: 41246616

This overview of mitral valve prolapse is for informational purposes only and does not constitute medical advice. Your cardiologist can interpret your echocardiogram, family history, and need for follow-up.

Guide contents mitral valve prolapse
Research & Literature
02 Recognizing Symptoms and Knowing When to Act