My cardiologist mentor, Dr. Lon Keith, use to correlate mitral valve prolapse with being bald. He'd remark that some men are bald, some are not - some people have mitral valve prolapse, some don't. When it becomes a problem is when the amount of prolapse of the leaflet of the valve increases and we have a larger amount of "regurgitation". Regurgitation is the amount of blood that backflows back through the valve. In the case of the mitral valve, it backflows back toward the lungs.

Trace means very little regurgitation and mild means a little and these are considered to be "normal". Moderate regurgitation can be concerning and severe regurgitation is very concerning.

A baseline echocardiogram can quantify the amount of regurgitation and identify if the leaflets of the valve are healthy.  This exam serves as a basis for follow up.

In my patients who have trace or mild regurgitation, I do recommend that they return annually for follow up to listen to their symptoms and listen to their heart, to compare to their previous assessments. Most of the time, there's no worsening of the prolapse or murmur over time.