Learn more about diseases that affect the valve between the left heart chambers, including mitral valve regurgitation and mitral valve stenosis.
Mitral valve disease is a problem with the valve located between the left heart chambers (left atrium and left ventricle).
Mitral valve disease includes:
Treatment for mitral valve disease depends on the severity of the condition and whether it is worsening. Sometimes, surgery is recommended to repair or replace the mitral valve.
Some people with mitral valve disease might not have symptoms for many years, if at all.
Signs and symptoms of mitral valve disease can include:
If you have a heart murmur or develop other signs or symptoms of mitral valve disease, your health care provider might recommend that you visit a doctor that specializes in heart diseases (cardiologist).
To understand the causes of mitral valve disease, it may be helpful to know how the heart works.
The mitral valve is one of four valves in the heart that keep blood flowing in the right direction. Each valve has flaps (leaflets) that open and close once during each heartbeat. If a valve doesn't open or close properly, blood flow through the heart to the body can be reduced.
In mitral valve regurgitation, the flaps don't close tightly. Blood flows backward when the valve is closed, making it harder for the heart to work properly.
In mitral valve stenosis, the valve opening narrows. The heart now must work harder to force blood through the smaller valve opening. If the opening in the valve becomes small enough, it can reduce blood flow from the left atrium to the left ventricle.
Mitral valve disease has many causes. Some forms of mitral valve disease can be present at birth (congenital heart defect).
Mitral valve disease may also develop later in life (acquired). For example, mitral valve stenosis is often caused by rheumatic fever. This fever is a complication of a strep infection that can affect the heart. When this happens, it's called rheumatic mitral valve disease.
Other causes of acquired mitral valve disease include:
Several things can increase the risk of mitral valve disease, including:
Mitral valve disease can cause many complications. Severe mitral valve regurgitation, for example, causes the heart to work harder, which can cause the left ventricle to enlarge and the heart muscle to weaken.
Other complications of mitral valve disease may include:
To diagnose mitral valve disease, including mitral valve stenosis and mitral valve regurgitation, a health care provider will usually perform a physical exam and ask questions about your medical history.
The health care provider will listen for a heart murmur, a sign of a mitral valve condition.
Tests to diagnose mitral valve disease may include:
Echocardiogram. Sound waves are used to produce video images of the heart in motion. An echocardiogram provides a closer look at the mitral valve and how well it's working. An echocardiogram can help in the diagnosis of congenital mitral valve disease, rheumatic mitral valve disease and other heart valve conditions.
Sometimes, a transesophageal echocardiogram may be done to get a closer look at the mitral valve. In this type of echocardiogram, a small transducer attached to the end of a tube is inserted down the tube leading from the mouth to the stomach (esophagus).
Cardiac catheterization. A health care provider threads a thin tube (catheter) through a blood vessel in the arm or groin to an artery in the heart and injects dye through the catheter. This makes the heart arteries show up more clearly on an X-ray.
Cardiac catheterization isn't often used to diagnose mitral valve disease, but it can be used if other tests haven't diagnosed the condition or to check to see if coronary artery disease is present.
After testing confirms a diagnosis of mitral or other heart valve disease, your health care provider may tell you the stage of disease. Staging helps determine the most appropriate treatment.
The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs.
Heart valve disease is staged into four basic groups:
Mitral valve disease treatment depends on the symptoms, the severity of the condition, and whether the condition is worsening.
A doctor trained in heart disease (cardiologist) typically provides care for people with mitral valve disease. Treatment of mitral valve disease might include monitoring the condition with regular follow-up visits. If you have mitral valve disease, you might be asked to:
A diseased or damaged mitral valve might eventually need to be repaired or replaced, even if no symptoms are present. Surgery for mitral valve disease includes mitral valve repair and mitral valve replacement.
If you need surgery for another heart condition, a surgeon might perform mitral valve repair or replacement at the same time.
Surgeons at some medical centers perform robot-assisted heart surgery, a type of minimally invasive heart surgery in which robotic arms are used to conduct the procedure.
During mitral valve repair surgery, the doctor might:
Other mitral valve repair procedures include:
During mitral valve replacement, the heart surgeon removes the mitral valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).
In some cases, a heart catheter procedure may be done to insert a replacement valve into a biological tissue valve that is no longer working properly. This is called a valve-in-valve procedure.
If you had mitral valve replacement with a mechanical valve, you'll need to take blood thinners for the rest of your life to prevent blood clots. Biological tissue valves break down (degenerate) over time and usually need to be replaced.
You'll have regular follow-up appointments with your health care provider to monitor your condition.
It's also important to make heart-healthy lifestyle changes, including:
If you have mitral valve disease and want to become pregnant, it's important to talk with a health care provider first. A health care provider can discuss which medications are safe to take during pregnancy, and whether a procedure is needed to treat a heart valve condition before pregnancy. Women with heart valve disease usually require close monitoring by a health care provider during pregnancy.
If you have mitral valve disease, here are some steps that may help you manage your condition:
If you think you have mitral valve disease, make an appointment to see your health care provider. Here's some information to help you prepare for your appointment.
For mitral valve disease, some basic questions to ask your health care provider include:
Don't hesitate to ask other questions you have.
Your health care provider is likely to ask you several questions, including:
November 12th, 2021