The mitral valve sits between the left atrium and the left ventricle and looks like two leaflets or flaps. Its job is to open and close, allowing blood to flow from the heart into the body. A healthy mitral valve ensures the blood keeps moving in the right direction, but when a mitral valve is not healthy, it may not close properly, allowing blood to leak backward into the heart. We call this mitral valve disease.
There are three types of MVD:
- Mitral valve prolapse is when the flaps of the mitral valve loosen and do not close as tightly as they should.
- Mitral valve regurgitation is a condition where a mitral valve allows blood to leak backward into the left atrium, rather than pushing it on through the chambers of the heart and out into the body. It can lead to complications like congestive heart failure, pulmonary hypertension, or atrial fibrillation. Mitral regurgitation can be acute (happening suddenly) or chronic (long-term).
- Mitral valve stenosis occurs when the flaps of the mitral valve become stiff or fuse together, causing a narrowing of the passage between the two left chambers of the heart. This can reduce blood flow to the body and even cause heart failure.
Who’s at risk for developing mitral valve disease?
Mitral valve regurgitation risk factors
Mitral valve regurgitation is common. Risk factors include:
- Mitral valve prolapse, the most common cause
- Inflammation of the heart lining
- Heart infection
- High blood pressure
- Coronary heart disease
- Rheumatic heart disease
- Congenital heart defects
- A failing left ventricle from other causes
- Connective tissue disorders such as Marfan’s disease
- Age-related wear-and-tear
Mitral valve stenosis risk factors
Thanks to greater access to antibiotics and cardiac care, mitral valve stenosis is rare in the United States, though it remains common throughout the world.
Risk factors for mitral valve stenosis include:
- Rheumatic fever, often a complication of strep throat or scarlet fever
- Heart defects present at birth
- Advanced age
- Tumors (such as atrial myxoma)
- Complications from previous mitral valve repair
What are the symptoms of mitral valve disease?
People with mitral valve disease can be completely asymptomatic and still require surgery to prevent long-term damage to the heart. When symptoms occur, they can be subtle because they usually develop slowly over time, years even.
Common symptoms include:
- Shortness of breath, especially when exercising or lying down
- Swelling of the feet, ankles & legs
- Rapid breathing
- Heart palpitations
- Cough, especially at night
- Excessive urination, especially at night
Many of these symptoms are associated with other conditions, so meeting with a physician can help rule out any other possible causes. Diagnosing these symptoms early can also help patients receive the best treatment to prevent long-term heart damage.
How is mitral valve disease treated?
At Georgia Heart Institute, cases of mitral valve disease will be evaluated by a full panel of Structural Heart Cardiologists and Cardiothoracic Surgeons. Together, these experts will review the specifics of your condition and determine the best and most successful approach to improve your heart health and quality of life.
Mild cases of MVD can be managed medically and some may not require treatment at all. Diuretics can reduce fluid buildup in the body, and nitrates and blood pressure medications help blood move forward rather than backward.
Mitral valve surgery
More severe cases of MVD are best treated with surgery. Although the decision to go ahead with a mitral valve procedure is complex and requires thorough evaluation. Patients in reasonably good health with severe mitral valve disease would benefit from surgery while maintaining a relatively low risk. Georgia Heart Institute offers robotic and minimally invasive mitral valve surgery, providing options for a wider array of patients who may be high risk for open heart surgery or simply prefer to avoid the pain and recovery involved with open heart surgery.
Some patients with mitral valve regurgitation may also benefit from a biventricular pacemaker.
For patients who are not good candidates for surgery, catheter-based procedures such as MitraClip may be a good option.
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