A group of health conditions that negatively affect your mitral valve is called mitral valve disease. This valve is located between the left atrium and the left ventricle. While some people may develop mild symptoms, others may experience severe and even life-threatening complications that negatively affect their quality of life.
In general, these disorders can be congenital (present at birth) or acquired over time. Typically, the mitral valve allows blood flow from the left atrium to the left ventricle. These chambers are responsible for holding oxygen-rich blood from the lungs and pumping it throughout the body. When something damages this valve, it may cause mild, moderate, or severe symptoms that may lead to life-threatening health problems (such as heart failure). Rarely, some people may develop multiple forms of mitral valve disease at the same time.
It is important to make the difference between heart valve disease and mitral valve disease. First refers to all heart valves. It means a person may have problems with multiple heart valves at the same time (including the mitral valve).
In general, these disorders occur differently. For instance, mitral valve stenosis affects about 1 in 100,000 people in the U.S. This type of mitral valve disease is more common in countries where rheumatic fever is common. However, mitral valve prolapse is more common than mitral valve stenosis, and it affects about 1 in 33 people in the United States. In addition, mitral valve regurgitation negatively affects approximately 1 in 10 people in the U.S.
Types of Mitral Valve Disease
Healthcare professionals have divided this condition into 3 main types based on the way the condition affects the mitral valve. However, to better understand these conditions, we should know the basic structure of this heart valve.
This valve is made up of 2 strong flaps of tissue (leaflets or cusps) that open and close in a coordinated way. It helps the blood to flow in a correct way, from the left atrium into the left ventricle. In other words, the mitral valve is a traffic director.
The diseases of the mitral valve negatively affect this heart valve, and it begins to work improperly. It may reduce or reverse blood flow, causing symptoms. Check the types of mitral valve disease below:
- Mitral valve stenosis – This type occurs when the valve’s flaps become stiff and thick, which significantly narrows the opening, causing reduced blood flow through the left atrium and left ventricle.
- Mitral valve prolapse – In such cases, the flaps of the mitral valve become too stretchy and bulge into the left atrium. As a result, it prevents the valve from closing properly and causes regurgitation (leaky valve).
- Mitral valve regurgitation – Mostly, this condition is known as a leaky valve or mitral insufficiency. When it occurs, the blood flows backward into the left atrium.
Symptoms
While usually people do not have any symptoms, in more severe cases, they can experience the following symptoms. Check some examples below:
- Migraines
- Orthostatic hypotension (low blood pressure)
- Dyspnea (shortness of breath)
- Swelling in the legs, ankles, or feet (also known as edema)
- Heart palpitations
- Mitral facies (such as a plum-colored flush in your cheeks)
- Extreme tiredness (fatigue)
- Dizziness
- Fainting
- Cough (sometimes with blood)
- Chest pain (angina)
Immediately visit a doctor for a diagnosis and treatment if any of the previous symptoms occur, because there are other conditions that may cause these symptoms. For example, atrial fibrillation (Afib), heart failure, and others.
Causes
Mitral valve disease may occur due to multiple reasons. Check some of them below:
- Congenital heart defects – These are heart problems present at birth (congenital). While some babies can be born with mitral valve disease, they may also experience other life-threatening defects that require immediate surgery.
- Connective tissue disorders – For example, Ehlers-Danlos syndrome, Marfan syndrome, and others.
- Endocarditis (heart infection)
- Left ventricle enlargement – It often occurs due to a myocardial infarction (also known as a heart attack) or cardiomyopathy.
- Aging – In older adults, Calcium slowly builds up on the heart valve, which increases the risk of mitral valve stenosis.
- Cancer treatments – Some people who get radiation therapy to treat cancer may develop mitral valve disease. In some cases, heart problems may occur 10 to 20 years after cancer treatment.
- Rheumatic fever – This is a serious infection that may cause heart valve damage if it is left untreated. Symptoms of heart damage may appear years or decades after the primary infection. Furthermore, this is one of the most common causes of mitral valve stenosis (especially in people born before 1943). However, new antibiotics can treat this bacterial infection and reduce the risk of life-threatening complications.
How to Prevent Mitral Valve Disease?
While most of the time, there is no way to prevent mitral valve disease, doctors may recommend some tips to reduce the risk of developing it with aging. For example:
- Physical exercise – Usually, it is recommended to aim for 30 minutes of physical exercise, at least 5 days a week, to maintain a healthy weight and support your heart and blood vessels.
- Administer medicines (especially antibiotics) exactly as recommended by your doctor. Otherwise, the condition may return, and it becomes more difficult to treat.
- Visit your doctor for a checkup each year
- Stop smoking – If you face difficulties with smoking cessation, discuss it with your physician.
- Limit or avoid alcoholic beverages
- Do not use recreational drugs (such as cocaine)
Diagnosis
Like the diagnosis of multiple health conditions, the diagnosis of mitral valve disease begins with a physical examination. In such cases, doctors may also use a stethoscope to listen to the heart muscle. Moreover, doctors use the following tests and procedures to rule out other disorders that may cause similar symptoms. These include:
- Electrocardiogram (EKG or ECG) – This is a painless and quick test used to measure the electrical activity of the heart. Usually, it helps identify irregular heart rhythms (arrhythmia).
- Chest X-ray – This is an imaging test used to show whether the left ventricle is enlarged or if fluid is building up in the lungs.
- Cardiac catheterization – This test helps doctors measure the pressure within the heart. It may confirm mitral valve stenosis. It is also used before surgery to check for coronary artery disease.
Treatment
While some people do not have symptoms and do not need treatment, doctors recommend treatments based on your symptoms. Check some examples below:
- Balloon valvotomy – During this procedure, doctors will use a catheter (a long and flexible tube with a lighted camera on the end) to separate the cusps of the mitral valve using a balloon.
- Medicines – The following medicines are often prescribed by doctors to manage hypertension, reduce swelling, and slow down the heart rate. These include diuretics (water pills), beta-blockers, and calcium channel blockers. Sometimes, they may prescribe anticoagulants (also called blood-thinners) to prevent or treat blood clots.
- Mitral valve repair surgery – This is one of the most common procedures used to treat mitral valve disease. It helps keep your valve and prevent some complications that may appear with a valve replacement.
- Mitral valve replacement surgery – When the previous surgery is not an option, doctors will replace the mitral valve.
- Minimally invasive mitral valve repair – This treatment involves some small cuts (incisions) and a quicker recovery. It often includes a right mini-thoracotomy, repair of the upper sternotomy, or robotically-assisted repair.
- Percutaneous interventions – It is another catheter-based treatment that is a good choice for people with an enlarged heart muscle, a weak heart, and other existing health problems.
- Percutaneous mitral valve replacement – In some cases, surgery to replace the mitral valve may be a high-risk procedure, and doctors will place a new valve inside a diseased mitral valve. For more details, discuss it with your doctor.
In addition, the previous treatment options may also cause some complications. For example, arrhythmia (irregular heart rhythm), bleeding, blood clots, myocardial infarction, infections, and others.
Frequently Asked Questions
How long can you live with mitral valve disease?
In general, the life expectancy for people with this disease varies significantly because of the following factors. Examples include the type and severity of the mitral valve disease, existing health problems, your response to treatment, age, and how fast you get treatment.
When should I go to the ER?
Immediately go to the nearest emergency room (ER) or call 911 if any of the following symptoms occur. For example, sudden and severe chest pain, irregular heartbeats, fainting, dizziness, severe weakness, sudden dyspnea (shortness of breath), or unexpected adverse reactions.
Who does mitral valve disease affect?
While this condition may affect anyone, some people are at higher risk compared to others because of the following factors. For example, congenital heart defects, heart infections, myocardial infarction, older adults, and others. In addition, while mitral valve prolapse mostly affects females, it is more dangerous if it happens in males. Ask your healthcare provider if you have any other questions.
