Mitral Valve Prolapse: Severity and Classification

Mitral valve prolapse (MVP) is systolic displacement of ≥1 mitral leaflet >2 mm above annular plane into left atrium. Most cases are benign, asymptomatic, and require no treatment.

Classification (by severity of regurgitation)

• Trivial/mild MR: Majority; normal life expectancy.
• Moderate/severe MR: May progress to LA enlargement, LV dilation, AF, heart failure — guideline-directed surgery (repair preferred) when symptomatic or LV dysfunction.

Not a "Class III heart condition." Heart failure classification (NYHA Class I–IV, ACC/AHA Stage A–D) describes functional capacity or disease progression, not MVP itself. Severe MR *can* lead to advanced HF stages, but MVP alone is not classified that way.

Follow-up

Asymptomatic mild MVP: echo every 3–5 years. Moderate MR: annually. Antibiotic prophylaxis for dental procedures only if prior IE, prosthetic valve, or congenital heart disease (per 2021 AHA/ACC).