Mitral valve disease
When the mitral valve does not work properly, your heart must work harder resulting in an enlarged, weakened heart
The mitral valve, one of the heart’s four valves, connects the left atrium to the left ventricle. Within the mitral valve are flaps, called leaflets, which open and close to allow or restrict blood flow in only one direction. The opening of the flaps allows blood to flow from the left atrium to the left ventricle. In turn, the flaps close to prevent the backflow of blood into the left atrium.
There are three types of mitral valve disease: mitral valve prolapse, mitral stenosis, and mitral regurgitation.
Mitral valve prolapse
Mitral valve prolapse is the most common valvular disorder in the United States, occurring in 2–3% of the population. Mitral valve prolapse occurs when the mitral valve flaps are unable to properly close, and instead one or both flaps bulge upward into the left atrium. In most cases, this condition is harmless and affected persons are unaware they are living with the condition.
The most common cause of mitral valve prolapse is myxomatous valve disease, when the valve flaps are abnormally stretchy. Some connective tissue disorders, such as Marfan syndrome, can also cause a person to develop this condition. Most people do not have symptoms, but an abnormal heartbeat may be detected during a physical examination. Common symptoms include chest pain, shortness of breath, irregular heartbeat, anxiety, and fainting. If you are presented with these symptoms, advanced diagnostic testing may include an echocardiography (ECHO) or cardiac magnetic resonance imaging (MRI).
Mitral valve prolapse may not always involve treatment. For those with worsening or severe symptoms, medical management, mitral valve repair surgery, or mitral valve replacement surgery may be recommended.
Mitral stenosis is the narrowing or blockage of the mitral valve, resulting in decreased blood flow to the left ventricle. The most common cause of mitral stenosis is rheumatic fever, a rare disease in the United States resulting from untreated strep throat or scarlet fever. Rheumatic fever may cause thickening, scarring, and calcification of the mitral flaps.
The most common signs and symptoms of mitral stenosis are shortness of breath, fatigue, irregular heartbeat, swollen feet or legs, and chest pain, with more advanced cases causing right-sided heart failure. Decrease in the size of the mitral opening increases the patient’s risk of developing atrial fibrillation, an irregular heart rate, and arterial thromboembolism, a blood clot that blocks blood flow in an artery.
Diagnostic testing, such as electrocardiogram (EKG), chest x-ray, and echocardiography (ECHO), may be completed to determine diagnosis and severity. Treatment of mitral stenosis includes medical management, catheter-based procedures, mitral valve repair or replacement surgery, or a minimally invasive approach.
Mitral regurgitation occurs when the mitral flaps fail to close properly and result in blood leakage from the left ventricle back into the left atrium. Leakage can increase blood pressure in the left atrium and enlarge the heart. Mitral regurgitation can cause increased pressure in the veins leading from the lungs to the heart, and severe mitral regurgitation cases may lead to congestion, or fluid buildup, in the lungs.
The most common cause of mitral regurgitation is myxomatous disease, having abnormally stretchy valve flaps. Other causes include coronary artery disease, cardiomyopathy, rheumatic heart disease and infective endocarditis. Patients may not show symptoms for years; when symptoms develop, most commonly patients experience shortness of breath, fatigue and irregular heartbeat caused by atrial fibrillation. If you are presented with these symptoms, diagnostic testing may include electrocardiogram (EKG), chest x-ray, echocardiography (ECHO) and cardiac magnetic resonance imaging (MRI).
Treatment for mild regurgitation may include medical management. However, mitral valve repair surgery, mitral valve replacement surgery or a minimally invasive approach is often recommended to treat patients with mitral regurgitation.