[30 years mitral valve prolapse--what has stayed the same?].

As a Result of echocardiographic diagnostic criteria that took too little account of underlying pathology, mitral valve prolapse has, in the past, been diagnosed far too frequently, and has been associated with commonly occurring unspecific symptoms (mitral valve prolapse syndrome). The results of epidemiological studies have led to a new definition of diagnostic criteria. The diagnosis mitral valve prolapse is established in the first instance by auscultation. Echocardiography supports the diagnosis, provides information about the prognosis, and, with a high level of reliability, detects complications. Major complications of this condition are endocarditis and mitral valve insufficiency, as also--less well documented--cerebral embolism and sudden heart death. Particularly at risk of developing complications are those patients with a systolic murmur reflecting an already present mitral valve insufficiency. This patient group must be monitored for progressive mitral insufficiency and, in the presence of relevant exposure, requires endocarditis prophylaxis.