A patient with mitral valve prolapse may show exercise intolerance that can be associated with exercise-induced worsening of regurgitant flow. This may impact survival.
Patient selection: mitral valve prolapse
Features of exercise intolerance may include:
(1) syncope
(2) worsening heart failure
(3) exertional dyspnea
(4) fatigue
(5) orthostatic hypotension
(6) dizziness
The exercise intolerance may be greater in the upright position compared to supine.
Echocardiographic findings during exercise that are associated with worse survival:
(1) increase in regurgitant volume across mitral valve >= 15 mL
(2) increase in effective regurgitant orifice area of mitral valve >= 10 square mm
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