Mitral Valve Disease

What is Mitral Valve Disease?

The mitral valve is located on the left side of the heart, separating the left atrium (upper heart chamber) and the left ventricle (lower heart chamber). The mitral valve has two leaflets - or flaps - that open and close to allow normal flow of blood between these two chambers of the heart.

When the heart is working normally, the left atrium gets blood from your lungs, and pumps the blood to the left ventricle through the open mitral valve. The mitral valve then closes as the left ventricle pumps blood through your arteries to the rest of the body.

When a person has mitral valve disease, the leaflets of the mitral valve do not work well – causing the valve to leak, or not allow enough blood through. This can damage the heart muscle and lead to poor health.

Types of Mitral Valve Disease

Two common conditions can affect the mitral valve's ability to regulate blood flow:

• Mitral Valve Regurgitation occurs when the leaflets do not close completely and become “floppy,” such as after a heart attack. This causes blood to leak back (regurgitate) into the left atrium and decrease blood flow to the rest of the body.
• Mitral Valve Stenosis occurs when the leaflets of the valve thicken and do not open completely, usually because of calcification. This results in the valve being too tight, and not allowing enough blood to move forward.

What Are the Symptoms of Mitral Valve Disease?

In some cases, a person with mitral valve disease might not experience symptoms for a long period of time, even years. But a person with some form of the disease may experience:

• Fatigue
• Shortness of breath, even when lying down
• Irregular heartbeat
• Heart murmur
• Swelling of the lower extremities
• Cough
• Lightheadedness
• Tightness or discomfort in the chest may also occur, and symptoms may worsen when your body is stressed.

If you’re experiencing any of these symptoms, talk with your doctor. To diagnose mitral valve disease, a doctor will listen to your heart and potentially order imaging tests such as an echocardiogram (ultrasound of the heart).

What Causes Mitral Valve Disease?

The causes of mitral valve disease vary depending on the type of disease. Mitral valve disease may be related to valve problems people are born with, or things that happen in life such as infections, radiation to treat cancer, or heart attacks. For many patients, mitral valve disease is simply due to aging.

Mitral valve regurgitation can be caused by a number of different heart problems, including a heart attack, rheumatic fever, and endocarditis, which is an inflammation of the heart’s lining and valves. Other conditions that people are born with, such as mitral valve prolapse, may lead to regurgitation later in life.

Mitral valve stenosis is usually the result of scarring caused by rheumatic fever. This condition, which primarily occurs in childhood, results from the body’s response to a strep infection. If the mitral valve becomes inflamed due to rheumatic fever, it’s known as rheumatic heart disease. As people age, the more common cause of mitral stenosis is calcium build up.

Treatment Options

Treatment for your condition will depend on the type of mitral valve disease, as well as the severity of the condition. In some cases, treatment may not even be necessary.

If treatment is needed, there are three main options — medications, transcatheter procedure, and surgery. While no medications can correct structural issues affecting the mitral valve, they can help ease symptoms.

A transcatheter procedure may include techniques to repair the valve, or a new valve to replace the old one. Transcatheter means that the procedure is done in a minimally-invasive way, most often through a small tube (or catheter) placed in a vein in the leg leading to the heart. This is similar to how stents are placed in blocked arteries. Sometimes, a surgical procedure is the best option, either through small incisions (openings) in the chest, or through open-chest surgery that allows additional procedures to be performed at the same time (like bypass surgery).

Your physician will explain the options available to you, as you work through the decision making process based on your unique situation, values and preferences.