All the following are true for mitral valve prolapse except

Ref Harrison 19 th ed pg 1546 Most patients are asymptomatic and remain so for their entire lives. However, in Noh America, MVP is now the most common cause of isolated severe MR requiring surgical treatment. Arrhythmias, most commonly ventricular premature contractions and paroxysmal supraventricular and ventricular tachycardia, as well as AF, have been repoed and may cause palpitations, light-headedness, and syncope.