Mitral Valve Prolapse

The natural history of mitral valve prolapse is extremely variable and depends on the extent of myxomatous degeneration, the degree of mitral regurgitation, and association with other conditions.

Mitral valve prolapse is usually a benign condition. In some cases, mitral regurgitation may be progressive, resulting in left ventricular (LV) and left atrial enlargement, atrial fibrillation, and congestive heart failure.

Waiting period

No recommended time frame

You should not certify the driver until etiology is confirmed and treatment has been shown to be adequate/effective, safe, and stable.

Decision

Maximum certification period — 1 year

Recommend to certify if:

As the medical examiner, you believe that the nature and severity of the medical condition of the driver does not endanger the health and safety of the driver and the public.

Recommend not to certify if:

The driver has:

• Symptoms or reduced effort tolerance due to mitral valve prolapse or mitral regurgitation.
• Ruptured chordae or flail leaflet.
• Systemic emboli.
• Atrial fibrillation.
• Syncope or documented ventricular tachycardia.
• Severe mitral regurgitation or LV dysfunction.

Monitoring/Testing

Exercise tolerance testing may be helpful to assess symptoms.

Drivers who have definite mitral regurgitation (even if mild) or markedly thickened leaflets, should have:

• Echocardiography at least annually.
• Clearance from a cardiovascular specialist who understands the functions and demands of commercial driving.

Follow-up

The driver should have an annual medical examination.

The complete text of the medical conference reports can be accessed from FMCSA Medical Reports.