This is not one of my favorite topics, but I am glad I did it.  I hear people all the time who have arrhythmias with their MVP, and the doctor tells them to go home and relax, there is nothing wrong. It certainly makes me wonder after doing the research on this subject.  I would say, anyone with an arrhythmia, with mild regurgitation should be making a visit to their doctors and asking some serious questions.

    Mitral valve prolapse is the most common underlying cardiac disorder.  Therefore it is not unusual to ask how many of the sudden deaths from heart attacks and arrhythmias are related to undiagnosed MVP.  It has been suggested in the past through out medical literature that in cases of sudden death, where there is no history of cardiac disease indicated by a murmur or cardiac enlargement, that MVP should be routinely checked for in an autopsy.

    Sudden deaths in patients with MVP have been recorded in the literature and arrhythmias are generally the cause.   It has been established, that many MVP patients have arrhythmias that are potentially dangerous, such as atrial premature complexes or contractions (35-90%),  atrial tachycardia (3-32%),  ventricular premature complexes or contractions (58-89%)  and a high incidence  of complex ventricular arrhythmias (43-56%)  and ventricular tachycardia (5-21%).

    MVP patients with lethal arrhythmias have what Kligfield calls "depressed ejection fraction" at rest. I interpret this as heart failure. It is an insufficient volume of blood being ejected form the heart to the rest of the body during a complete cardiac cycle.  The result is that the blood that should be pumped out remains in the ventricles  and therefore, the heart dilated and eventually the muscle thickens or hypertrophies from a prolonged effort to meet the oxygen demands of the body.  If blood remains in the ventricle, there is the tendency for coagulation and thus the formation of thrombi.

   The general physician should look out for patients with MVP  who have a high risk of sudden death. Specifically, arrhythmias should not be looked at as insignificant palpitations or a nuisance.  Even those with mild regurgitation, evident by late systolic murmur are at risk.   The risk of sudden death could be as much as 50 to 100 times greater in patients who have mitral regurgitation and MVP.  These are frightening odds.  More dangerous arrhythmias can be found in patients with regurgitation and MVP.  

   It has been proven that  patients who have MVP and are at high risk for sudden death, can be identified.   Medication must be given to minimize the more common arrhythmia, and other strategies must be adopted to prevent the more serious arrhythmias. 

    While the yearly mortality of successfully controlled patients ranged between 2.3 and 2.8%, the yearly mortality rate in those in whom the arrhythmias were inadequately controlled ranged form 43.6 to 56%

     A study published in 1999 of 200 cases of sudden death in the young (less than 35 yrs old) showed MVP to be  the cause  at 10%.  Sudden death was cerebral in 7.5%, respiratory in 5%, and cardiovascular in 81.5%.  Unexplained deaths were 6%.  Most of the diseases although asymptomatic, were potentially detectable during life with the proper imaging test.

     A case study of 22 young competitive athletes ranging in age from 11 to 35.  In 18 cases death occurred during or immediately after a competitive sport activity.  In 17 cases death was due to arrhythmia cardiac arrest.  2 cases where due to MVP.

     A study done on 1000 adults under aged 65 with no previous history who suffered a sudden death.  Mitral valve prolapse was found 125 times.