Recent data on mitral valve prolapse and magnesium deficit

Idiopathic mitral valve prolapse (IMVP) is a widespread disease. IMVP may be latent, but most patients describe a great variety of symptoms. The clinical pictures of IMVP and of latent tetany are superimposed with regard to Mg deficit. IMVP appears as a late complication of latent tetany due to magnesium deficit (LTMD). The Mg deficit has various causes: insufficient Mg intake (especially during slimming diets), and depletion of Mg provoked by stress, coffee excess, corticosteroids or catecholamine excess. The high prevalence in women is mainly due to the ovarian hormones. Constitutional factors such as the HLA Bw35 antigen and the behavioural type A favour Mg depletion. The HLA-Bw35-positive individuals show a lower level of tissue Mg. In the development of the valvular lesion there are some other associated factors apart from Mg deficit which alter collagen metabolism: ascorbic acid deficit, febrile illnesses, corticosteroid excess. Symptomatology is dominated by the latent tetany syndrome. Palpitations and precordial pain are the most frequent cardiac symptoms. The click and mid-late systolic murmer do not appear in all IMVP cases. In clinical investigation the following tests are indispensable: echocardiogram, electrocardiogram, evaluation of plasma and erythrocyte Mg, calcaemia and calciuria. In particular cases more sophisticated studies are necessary. Therapy based on Mg should be applied consistently and for long periods of time. Mg therapy results in the control of latent tetany as well as in morphologic recovery. The administration of Mg in LT prevents the development of IMVP.