Heart and Circulatory System

Mitral valve prolapse (MVP) is a fairly common cardiac disorder in which the mitral valve does not close properly, allowing blood to backflow into the left atrium. The mitral valve is comprised of two flaps of tissue that open and close in a rhythmic manner to keep the blood flowing in one direction—from upper to lower heart chambers.

When the mitral valve malfunctions, the tissue flaps may "billow" slightly into the upper chamber to prevent the valve from closing completely. A faint click or whooshing sound may be heard through a stethoscope, or a heart murmur may develop even though the heart is functioning normally.

It is estimated that 5 percent or more of the adult population of the United States have mitral valve prolapse, also known as Barlow's syndrome, floppy valve syndrome, and ballooning mitral valve syndrome. For most, the condition is harmless, requiring no lifestyle changes. Because of the absence of symptoms, many people are unaware of their condition. In some cases of MVP, however, the condition may eventually require treatment.

When symptoms are present they vary widely from person to person, are usually mild, and progress gradually. Common symptoms may include:

• Racing or irregular heartbeat (arrhythmia)
• Lightheadedness, dizziness
• Chest discomfort (unrelated to heart attack or coronary artery disease)
• Shortness of breath, often when lying down or after exertion
• Palpitations
• Fatigue
• Headaches

The FAA currently allows individuals with mitral valve prolapse, who are without symptoms, to continue flying and report the condition at their next FAA physical exam. Three months prior to the FAA exam, you should forward to the FAA:

1. Past medical records pertaining to the mitral prolapse.
2. A current status letter from your doctor that discusses your functional capacity, cardiovascular risk factors, and prognosis for incapacitation.
3. The report of a recent resting echocardiogram.

When mitral valve prolapse occurs with symptoms, the FAA requires self-grounding until the symptoms are controlled. Three months prior to the first AME visit following your diagnosis, you should forward to the FAA a cardiovascular evaluation that includes:

1. An assessment of personal and family medical history (mother, father, siblings)
2. Cardiac examination and general physical examination
3. Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides
4. Statement regarding your medication dosage and frequency, functional capacity, modifiable cardiovascular risk factors, motivation for necessary change, and prognosis for incapacitation
5. 24-hour Holter Monitor report
6. Maximal exercise treadmill stress test demonstrating functional capacity equivalent to completion of Stage III (9 minutes) of the 12-lead Bruce protocol. If beta-blockers, calcium channel blockers, or digitalis-type medications are being taken to inhibit heart rate response, it may be necessary to discontinue the drugs for 48 hours before testing in order to attain adequate heart rate. Consult with your physician before discontinuing medication. Submit report(s) and all original tracings.

How/Where to Submit to the FAA

Helps you find the contact information for submitting your medical records.

Updated April 2016