Forty years ago, the first article was published reporting that individuals with keratoconus (KC) appeared to have a higher-than-average incidence of the cardiac condition Mitral Valve Prolapse (MVP).  Later, 50 patients who had undergone corneal transplant because of severe keratoconus were compared to 50 control subjects.  The authors found more than half (58%) of the patients with progressive KC showed evidence of MVP, against just 7% of the controls.  

In 2020, an article that further looked at the association between the two conditions concluded that patients with either KC or MVP had an increased risk of also being diagnosed with the second condition.

Heart valves, like the cornea, are composed of collagen.  Patients with MVP have valves that are thinner, more stretchy, and more prone to deformation.  Mitral Valve Prolapse takes place when the weaken heart valve between the left atrium and left ventricle bulges forward or collapses backward (prolapse) during a heartbeat.  While most patients are asymptomatic, in some cases, the ‘bulging’ or fragile heart valve regurgitates, or causes a backward flow of blood.  Patients with these leaky valves are more inclined to become easily fatigued, or experience chest pain or dizziness, some of the common signs of MVP.  And the heart itself can also become damaged over time. 

Dr. William Sheppard, MD, a primary care physician in Newberry, Michigan, welcomes patients sharing information about their KC during their annual exam, “When a primary care physician learns that a patient has a collagen-related condition like keratoconus, the doctor will pay increased attention to the heart exam.  A slight murmur that may be disregarded in the general population may seem more meaningful and a cause for follow-up.”  Dr. Sheppard added, “I welcome learning that my patients have been diagnosed with keratoconus, because it alerts me to the possibility that the patient’s heart valve may also be weakened.  I can be more attuned to any cardiac changes I observe and can recommend an intervention earlier that may improve my patient’s quality of life.”  

Remember, sharing information about your keratoconus with your primary care doctor may provide useful information about other conditions that may affect your overall health.

Reference: Siordia JA, Franco JC, The Association Between Keratoconus and Mitral Vale Prolapse: A Meta-Analysis, Current Cardioogy Reviews, 16:147-152, 2020.

Dr. William Sheppard MD is Board Certified in Family Medicine and for several years was a member of the adjunct teaching faculty at Michigan State University College of Human Medicine.  Dr. Sheppard delivers rural healthcare as a hospitalist and primary care practitioner to the residents of Michigan’s Upper Peninsula.