Mitral Valve Disease
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The mitral valve sits between the heart’s two left chambers (atrium and ventricle).
There are two types of mitral valve disease:
- Mitral regurgitation
- Mitral stenosis
Mitral regurgitation, also called mitral valve regurgitation or mitral valve insufficiency, is the most common heart valve disorder and occurs when blood leaks back through the mitral valve as the lower heart chambers (ventricles) are pumping. Regurgitation is most often caused by mitral valve prolapse, in which the valve flaps, or leaflets, bulge into the upper-left heart chamber (atrium) during ventricle contraction.
Mitral stenosis, also called mitral valve stenosis, involves narrowing of the valve opening, which restricts blood from flowing through the left heart chambers (from the atrium to the ventricle). Mitral valve stenosis typically results from rheumatic fever, which is very rare in the United States. In older patients mitral stenosis may occur from a buildup of calcium within and immediately around the mitral valve leaflets.
When blood leaks back into or builds up in the atrium, it can increase blood pressure in the atrium, causing it to enlarge and increasing pressure in the pulmonary veins. Severe regurgitation can cause fluid to build up in the lungs (congestion). An enlarged atrium may also develop atrial fibrillation, which reduces the heart’s ability to pump properly.
Symptoms of Mitral Valve Disease
People with mild valve disease may not have any symptoms. When regurgitation or stenosis is more severe, the following symptoms may occur:
- Palpitations (sensation of feeling your heartbeat)
- Shortness of breath during activity
- Weakness or fatigue
- Swelling of the legs, ankles or feet
- Chest pain or pressure, especially during activity
Treating Mitral Valve Disease
Treatment is often not necessary in the absence of symptoms, but cardiologists at Houston Methodist will perform a physical examination and ask about your medical history to detect the severity of your condition.
Mild symptoms of mitral valve disease can be treated with medications to reduce blood pressure, improve the heart’s ability to pump blood or to deal with infection. If mild, mitral stenosis can often treated with medication alone for many years.
Surgical repair or replacement of the valve or other advanced techniques are usually necessary for more severe symptoms of mitral valve disease, whether it be regurgitation or stenosis.
If mitral stenosis is detected, one possible treatment is percutaneous mitral balloon valvuloplasty. This is a nonsurgical procedure, in which a catheter (medical tubing) is introduced into a blood vessel and guided to the narrowed mitral valve. A balloon attached to the tube is then inflated, widening the mitral valve and allowing for better blood flow. Another option is mitral valve replacement, in which a mechanical or tissue valve is inserted in place of the damaged valve.
If severe mitral regurgitation is detected, there are two treatment options.
- Mitral valve repair suits most people with mitral valve damage because repair is preferred over replacement.
- Mitral valve replacement involves removing the damaged valve and replacing it with an artificial mechanical or tissue valve.
Perhaps the best way to learn about our valve specialists is through our patients. We invite you to read these inspiring stories.