Floppy Mitral Valve/Mitral Valve Prolapse: Diagnosis and Clinical Classification in This Continuing Odyssey

Few disorders have evoked more interest and controversy in cardiology over recent centuries than floppy mitral valve (FMV)/mitral valve prolapse (MVP). FMV/MVP is a complex entity with multiple genotypes and phenotypes in which the clinical manifestations may not be directly related to the severity of mitral regurgitation. Furthermore, there is a lack of a precise definition of this complex entity. This review emphasises a diagnostic approach based mostly on FMV rather than solely on MVP, which frequently may be a non-specific finding. In addition, a clinical classification of FMV/MVP is presented that separates patients with symptoms not directly related to the severity of mitral regurgitation (referred to as FMV/MVP syndrome) from those in whom symptoms are directly related to mitral regurgitation and its complications. In the future, genetic variants will likely be incorporated into the diagnostic classification and management of this complex entity as this odyssey continues.