Physical exam for mitral valve prolapse

During the physical exam, the health professional may look for signs of mitral valve prolapse (MVP) or its complications by:

• Taking your blood pressure.
• Looking for certain body features that may be associated with MVP, such as low body weight, long arms, a flat rib cage, and loose joints. MVP is often seen in people with these body features.
• Listening to your heartbeat as you change positions (sitting, standing, squatting, and lying down) and when you are holding your breath or making fists.
  • The health professional will listen for a click or murmur or a click followed by a murmur. If MVP is present, specific changes in the nature and timing of clicks and murmurs will occur as you change positions or perform the other tasks.¹ Clicks are often difficult to hear during a physical exam.
  • The heart sounds associated with MVP may not always be present during a physical exam. You may need to have repeat exams or see a heart specialist (cardiologist) if you have symptoms of MVP.

If a murmur is heard during the physical exam, repeat exams may be needed to determine whether the murmur is due to MVP or other heart conditions. The distinction may be important when deciding on treatment.²

In rare cases, symptoms of heart failure may develop as a result of MVP and severe mitral valve regurgitation. If you show signs of these conditions, your doctor likely will also examine you for signs of heart failure by:

• Listening for abnormal sounds in your lungs during breathing. Crackling sounds in the lungs during breathing may be a sign of fluid in the lungs.
• Checking your legs for swelling (edema). Swelling in the legs may be a sign that the heart is not able to pump blood effectively to the rest of the body (heart failure).

Citations

1. Bouknight DP, O'Rourke RA (2000). Current management of mitral valve prolapse. American Family Physician, 61(11): 3343–3350.

2. Fontana ME (2005). Mitral valve prolapse. In RE Rakel, ET Bope, eds., Conn's Current Therapy 2005, pp. 376–379. Philadelphia: Elsevier Inc.