The pathophysiology of mitral valve prolapse involves ballooning of mitral valve leaflets into the left atrium. Prolapse of the leaflets is caused by myxomatous degeneration which involves the loss of fibrillar collagen and elastin in the extracellular matrix. It can also be caused by secondary causes such as left ventricular dilatation and inflammatory diseases that cause remodeling of the valves ( Kumar, Abbas & Aster, 2018) . Mitral valve prolapse results in mitral regurgitation of blood during left ventricular systole.
The clinical manifestations of mitral valve prolapse involves mitral regurgitation and its effects on pulmonary and systemic circulation such as atypical chest pain, arrhythmias, mid-systolic click, and a regurgitation murmur heard on auscultation. Other symptoms are due to autonomic nervous system dysfunction such as palpitations, orthostatic hypotension, and syncope (Boudoulas, Pitsis, & Boudoulas, 2016) . Comorbidities such as left ventricular dilation, thromboembolic phenomena, and infective endocarditis may occur.
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Mitral valve prolapse causes can be divided into primary and secondary causes. The primary causes involve genetic predisposition to myxomatous degeneration of the valves (Pislaru et al., 2018). The secondary causes such as rheumatic heart disease, hypertrophic cardiomyopathy, and acute myocardial infarction lead to valvular damage. Secondary causes are modifiable risk factors. Early intervention such as alcohol consumption reduction, adherence to treatment and lifestyle changes can prevent disease complications that lead to mitral valve prolapse.
The non-modifiable risk factors such as race, gender, and age involve genetic mutations that express their phenotype as myxomatous degeneration of the valves. Degenerative changes are more likely to occur in older people due to the repeated and sustained mechanical stress on the valves. Mitral valve prolapse occurs more commonly in women than in men (McNeely & Vassileva, 2016) . This could be due to a higher prevalence of connective tissue disease in women which leads to degeneration.
References
Boudoulas, K. D., Pitsis, A. A., & Boudoulas, H. (2016). Floppy Mitral Valve (FMV)–Mitral Valve Prolapse (MVP)–Mitral Valvular Regurgitation and FMV/MVP Syndrome. Hellenic Journal of Cardiology , 57 (2), 73-85.
Kumar, V., Abbas, A. K., & Aster, J. C. (2017). Robbins basic pathology e-book . Elsevier Health Sciences.
McNeely, C., & Vassileva, C. (2016). Mitral valve surgery in women: another target for eradicating sex inequality. Circulation: Cardiovascular Quality and Outcomes , 9 (2_suppl_1), S94-S96.
Pislaru, S., Enriquez-Sarano, M., Otto, C. M., & Yeon, S. B. (2018). Definition and diagnosis of mitral valve prolapse.
