How Is Mitral Valve Prolapse Diagnosed?

Mitral valve prolapse (MVP) is most often found during a routine physical exam when your doctor uses a stethoscope to listen to your heart. Your doctor listens for a certain “click” and/or murmur. Stretched valve flaps, as seen in MVP, can make a clicking sound as they shut. If the valve is leaking blood back into the atrium, a murmur or whooshing sound can often be heard. However, these abnormal heart sounds may come and go, so they may not be heard at the time of an exam, even if you have MVP. As a result, diagnostic tests and procedures may also be needed to diagnose MVP.

Diagnostic Tests and Procedures

Echocardiogram

An echocardiogram is the most useful test for diagnosing MVP. This test uses sound waves to create a moving picture of your heart. An echocardiogram provides information about the size and shape of your heart and how well your heart chambers and valves are functioning. The test also can identify areas of poor blood flow to the heart, areas of heart muscle that are not contracting normally, and previous injury to the heart muscle caused by poor blood flow. The echocardiogram is a painless test that’s used to look for prolapse of the mitral valve flaps and for backflow (regurgitation) of blood through the leaky valve.

There are several different types of echocardiograms, including a stress echocardiogram. During this test, an echocardiogram is done both before and after your heart is stressed either by having you exercise or by injecting a medicine into your bloodstream that makes your heart beat faster and work harder. A stress echocardiogram is usually done to find out if you have decreased blood flow to your heart (coronary artery disease).

Echocardiography also can be performed through your esophagus (the tube leading from your mouth to your stomach) to get a closer look at the mitral valve. A tiny probe in your esophagus takes sound wave pictures of your heart. This form of echocardiogram is called a transesophageal echocardiogram, or TEE.
Doppler Ultrasound

A Doppler ultrasound is part of the echocardiogram test. The Doppler ultrasound is used to show the speed and direction of blood flow through the mitral valve.

Other tests that can help diagnose MVP are:

• A chest x ray, which is used to look for fluid in your lungs or to see if your heart is enlarged.
• An EKG (electrocardiogram), which charts the electrical activity of your heart. The EKG can show abnormal heartbeats, damage to the heart muscle, and enlargement of the heart.