How can I differentiate between mitral valve prolapse and other causes of similar symptoms in my patients?

To differentiate mitral valve prolapse (MVP) from other causes of similar symptoms such as palpitations, chest pain, or dyspnoea, a thorough clinical assessment combined with targeted investigations is essential. Clinically, MVP often presents with a characteristic mid-to-late systolic click followed by a late systolic murmur best heard at the cardiac apex, which may vary with body position and maneuvers that alter left ventricular volume ¹. These auscultatory findings help distinguish MVP from other valvular or cardiac conditions that may cause similar symptoms but lack this specific murmur pattern.

Echocardiography is the definitive diagnostic tool to confirm MVP by visualising the systolic displacement of one or both mitral valve leaflets into the left atrium beyond the mitral annulus, which is not seen in other causes of similar symptoms ¹. Echocardiographic assessment also helps exclude other structural heart diseases that can mimic MVP symptoms, such as hypertrophic cardiomyopathy or other valvular abnormalities (Rueda and Arvan, 1988).

Additional investigations such as ECG and ambulatory monitoring may be used to evaluate arrhythmias, which can be associated with MVP but are also common in other cardiac conditions. The absence of typical auscultatory findings and echocardiographic evidence of leaflet prolapse should prompt consideration of alternative diagnoses.

In summary, the combination of characteristic auscultatory findings and confirmatory echocardiography is key to differentiating MVP from other causes of similar symptoms in patients presenting in general practice ¹ (Rueda and Arvan, 1988).