Valve replacement, though often of great benefit hemodynamically, is inconsistent with a career in military aviation. Antibiotic prophylaxis against recurrent ARF is also not disqualifying. Primary mitral valve prolapse affects women more commonly than men and may be inherited as an autosomal dominant trait. Most individuals with idiopathic mitral valve prolapse areasymptomatic, but some experience atypical chest pain, fatigue, dizziness, and syncope. About 50 percent of patients have arrhythmias, including PSVT, PVC's, AV blocks, and V-tach.
Some studies indicate an increased risk of sudden death.
A definitive diagnosis may be made by ascultation. Single or multiple mid- to late systolic clicks associated with a late systolic crescendo murmur are characteristic. A definitive diagnosis may also be made by two dimensional echo. Definite systolic prolapse of one or both mitral leaflets and the point of coaptationabove the mitral annulus on multiple views should be demonstrated. An echocardiographic diagnosis of MVP should not be based on the apical four chamber view alone.