What are the indications for referring a patient with mitral valve prolapse to a cardiologist?

Indications for referring a patient with mitral valve prolapse to a cardiologist include:

• Presence of moderate or severe mitral valve disease detected on echocardiography, as referral is recommended for adults with moderate or severe valve disease of any type ¹.
• Symptomatic severe mitral valve disease, such as symptoms of heart failure, angina, or breathlessness related to the valve condition, warrants specialist assessment ¹.
• Asymptomatic severe primary mitral regurgitation with echocardiographic findings including left ventricular ejection fraction (LVEF) less than 60%, end systolic diameter (ESD) more than 45 mm or indexed ESDI more than 22 mm/m2, or increased systolic pulmonary artery pressure above 60 mmHg on exercise testing should be referred for consideration of intervention ¹.
• Patients with mitral valve prolapse who have atrial fibrillation or elevated systolic pulmonary artery pressure (>50 mmHg at rest) should be considered for referral due to increased risk and potential need for intervention ¹.
• Pregnant women or women considering pregnancy with moderate or severe mitral valve disease should be referred to a cardiologist with expertise in pregnancy and valve disease ¹.

Referral is generally guided by echocardiographic findings and clinical symptoms, with the aim to assess the severity of valve dysfunction and determine the need for intervention or closer monitoring ¹.