The mitral valve located between the left heart chambers; left atrium and the left ventricle. This valve has two leaflets that allow the blood to flow properly in the right direction (from your left atrium to your left ventricle) and prevent it from backward flowing.
Mitral valve disease occurs when the valve is not working properly and doesn’t prevent blood to flow backward into the left atrium. Resultantly, the heart couldn’t pump sufficient blood out of the left ventricular chamber to supply it to the other body parts.
Most people experience the symptoms of mitral valve disease but in rare cases, it doesn’t show any symptoms. This disease should be diagnosed and treated well before time, otherwise, it can lead to severe life-threatening heart conditions.
Types of Mitral Valve Disease:
- Mitral Valve Regurgitation: It is the most common type of heart valve disease in which the valve between the left atrium and left ventricle doesn’t close completely, allowing blood to flow backward into the left atrium. Mitral valve regurgitation can also be named Mitral regurgitation (MR), Mitral insufficiency, and Mitral incompetence.
- Mitral Valve Prolapses: This disease occurs when the valve covering becomes bulge instead of closing completely. It also causes backward blood flow into the left atrium.
- Mitral Valve Stenosis: This disease makes the valve opening thick, stiff, and narrow which prevents the circulation of enough blood into your left ventricle.
Overall Symptoms of Mitral Valve Disease:
The patients suffering from Mitral Valve Disease reflects its following symptoms;
- Irregular heart sound (heart murmur)
- Irregular heartbeat (arrhythmia)
- Shortness of breath (dyspnea)
- Sensation of a fluttering heartbeat (palpitations)
- Swollen on the feet, legs, and ankles (edema)
- Chest pain or tightness
- Trouble breathing after exercise
Mitral Valve Causes:
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 closes 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 possible causes of mitral valve regurgitation include:
- Mitral valve prolapse: In this condition, the mitral valve’s flaps bulge back into the left upper heart chamber (atrium) when the heart squeezes (contracts). This common heart problem can prevent the mitral valve from closing tightly and cause blood to flow backward.
- Rheumatic fever: Rheumatic fever is a complication of untreated strep throat. Rheumatic fever can damage the mitral valve, leading to mitral valve regurgitation early or later in life. If rheumatic fever causes mitral valve disease, the condition is called rheumatic mitral valve disease. Rheumatic fever is rare in the United States.
- Heart attack: A heart attack can damage the area of the heart muscle that supports the mitral valve. If heart attack damage is very extensive, the event can cause sudden and severe mitral valve regurgitation. A leaky mitral valve caused by a heart attack is called ischemic mitral regurgitation.
- Heart problem present at birth (congenital heart defect): Some people are born with heart structure problems, including damaged heart valves.
- Thickening of the heart muscle (cardiomyopathy): Cardiomyopathy makes it harder for the heart to pump blood to the rest of the body. The condition can affect mitral valve function and may lead to regurgitation. Types of cardiomyopathy linked to mitral valve regurgitation include dilated cardiomyopathy and hypertrophic cardiomyopathy.
- Damaged tissue cords: Over time, the pieces of tissue that hold the flaps of the mitral valve to the heart wall may stretch or tear, especially in people with mitral valve prolapse. A tear can cause blood leakage through the mitral valve suddenly and may require mitral valve repair surgery. A chest injury also can cause rupture of the cords.
- Endocarditis: The mitral valve may be damaged by an infection of the lining of the heart (endocarditis) that can involve heart valves.
- Radiation therapy: Rarely, radiation therapy for cancer that is focused on the chest area can lead to mitral valve regurgitation.
Several things can increase the risk of mitral valve disease, including:
- Older age.
- Certain infections that affect the heart.
- Heart attack and some types of heart disease.
- Use of certain drugs.
- Heart condition present at birth (congenital heart defect).
- Radiation to the chest.
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:
- Irregular and often rapid heart rate (atrial fibrillation).
- High blood pressure in the blood vessels in the lungs (pulmonary hypertension).
- Blood clots.
- Congestive heart failure.
How is mitral valve disease diagnosed?
If your doctor suspects that you may have mitral valve disease, they will listen to your heart with a stethoscope. Unusual sounds or rhythm patterns can help them diagnose what’s going on. Your doctor may order additional tests to help confirm a mitral valve disease diagnosis.
a. Imaging tests:
- Echocardiogram: This test uses ultrasound waves to produce images of the heart’s structure and function.
- X-ray: This common test produces images on a computer or film by sending X-ray particles through the body.
- Transesophageal echocardiogram: This test produces a more detailed image of your heart than a traditional echocardiogram. During the procedure, your doctor threads a device emitting ultrasound waves into your esophagus, which is located right behind the heart.
- Cardiac catheterization: This procedure allows your doctor to do a variety of tests, including getting an image of the heart’s blood vessels. During the procedure, your doctor inserts a long, thin tube into your arm, upper thigh, or neck and threads it up to your heart.
- Electrocardiogram(ECG or EKG): This test records your heart’s electrical activity.
- Holter monitoring: This is a portable monitoring device that records your heart’s electrical activity over some time, usually 24 to 48 hours.
b. Tests to monitor heart activity:
Stress tests: Your doctor may want to monitor you while you exercise to determine how your heart responds to physical stress.
How is mitral valve disease treated?
Treatment for mitral valve disease may not be necessary, depending on the severity of your condition and symptoms. If your case is severe enough, there are three possible treatments or a combination of treatments that may correct your condition.
Drugs and medication:
If treatment is necessary, your doctor may begin by treating you with medications. There are no medications that can fix the structural issues with your mitral valve. Some medications can ease your symptoms or prevent them from getting worse. These medications may include:
- Antiarrhythmics, to treat abnormal heart rhythms.
- Anticoagulants, to thin your blood.
- Beta-blockers, to slow your heart rate.
- Diuretics, to reduce the accumulation of fluid in your lungs.
In some cases, your doctor may need to perform medical procedures. For example, in cases of mitral valve stenosis, your doctor may be able to use a balloon to open up the valve in a procedure called balloon valvuloplasty.
In severe cases, surgery might be necessary. Your doctor might be able to surgically repair your existing mitral valve to make it function properly. If that isn’t possible, you may need to have your mitral valve replaced with a new one. The replacement might be either biological or mechanical. The biological replacement might be obtained from a cow, pig, or human cadaver.