Mitral Valve Disease
The mitral valve controls blood flow between the upper (atrium) and lower (ventricle) chambers on the left side of the heart. Mitral valve disease refers to damage to the mitral valve that causes it to function improperly.
Mitral Valve Disease Symptoms and Diagnosis
Among the most common problems involving the mitral valve are:
- Mitral valve prolapse, when the valve’s leaflets (which control blood flow) do not close properly.
- Mitral valve regurgitation, when the valve does not close tightly enough, resulting in backward flow or “leaking” of blood from the left ventricle into the left atrium.
- Mitral valve stenosis, or the narrowing of the mitral valve, which causes a blockage between the left chambers of your heart.
- Mitral valve endocarditis, a bacterial or fungal infection of the mitral valve.
Symptoms of mitral valve disease may vary depending on the type of condition you have. The most common symptoms include:
- Heart palpitations
- Shortness of breath, especially with exertion
- Cough, especially at night or when lying down
- Dizziness, lightheadedness and/or fainting
- Swollen ankles, feet or abdomen
- Chest discomfort or pain (angina)
- A new heart murmur or arrhythmia
Most people who have mitral valve prolapse often do not have any symptoms. Symptoms of mitral valve endocarditis may also include flu-like symptoms and blood in the urine.
Causes & Risk Factors
Risk factors vary depending on the type of mitral valve disease; however, many people who have mitral valve disease are born with it or another congenital heart defect, and/or have a family history of mitral valve disease.
Having a history of mitral valve prolapse also puts you at a higher risk of developing mitral valve regurgitation and mitral valve endocarditis.
Mitral valve prolapse is most often found during a routine physical examine, as a certain “click” and/or murmur — the abnormal valve leaflet shutting — can be heard through a stethoscope. If the valve is leaking blood back into the atrium (mitral valve regurgitation), a murmur or whooshing sound may be heard.
Mitral valve endocarditis can be detected through blood cultures that show particular bacteria causing the infection.
Tests to help diagnose mitral valve disease may include:
- Electrocardiogram (EKG or ECG)
- Doppler ultrasound
- Transesophageal echocardiogram (TEE)
- Chest X-ray
- Holter monitor
- Coronary catheterization
Mitral Valve Disease Treatment at BIDMC
If you don’t have any symptoms of mitral valve disease, or if your symptoms are mild, your doctor may simply monitor your condition on a regular basis.
To help control any symptoms you are having, medications may be prescribed, including beta-blockers.
Mitral valve endocarditis can be fatal if not treated. Treatment typically involves high doses of intravenous antibiotics for up to six weeks.
If you have severe symptoms and/or if your mitral valve is damaged or abnormal, surgery may be necessary to repair the valve and its function. Surgical options include:
- Mitral valve repair, to fix the faulty valve
- Mitral valve replacement, using a valve that can be mechanical, or made of porcine (pig) or bovine (cow) tissue
Balloon valvuloplasty, a less-invasive approach than valve surgery, is often the preferred option if you have mitral valve stenosis. Balloon valvuloplasty involves inserting a flexible catheter (thin tube), with a balloon at its tip, through a small incision in the groin and threading it into the heart. The balloon is inflated inside the narrowed mitral valve, opening it and improving blood flow, and the catheter is removed. Balloon valvuloplasty is often as successful as surgery depending on the structure of the mitral valve.