Overview
Mitral valve disease refers to a problem with the valve located between the left heart chambers (left atrium and left ventricle) called the mitral valve. It includes conditions such as mitral valve regurgitation and mitral valve stenosis. In mitral valve regurgitation, the valve flaps (leaflets) may not close tightly, causing blood to leak backward. In mitral valve stenosis, the flaps become thick or stiff, narrowing the valve opening and reducing blood flow. Treatment depends on the severity of the condition and whether it's worsening. Surgery may be recommended to repair or replace the mitral valve.
Understanding the disease
Symptoms
The symptoms of mitral valve disease may include fatigue, irregular heart sound (heart murmur), irregular heartbeat, and shortness of breath. Mitral valve stenosis symptoms can include shortness of breath, especially with activity or when lying down, fatigue, swollen feet or legs, sensations of a fast, fluttering or pounding heartbeat, dizziness or fainting, and irregular heart sound. Mitral valve regurgitation symptoms can be mild and progress slowly, or they can develop quickly and cause sudden signs and symptoms, such as fatigue, irregular heartbeat (arrhythmia), and a sound of blood flow across the valve (heart murmur). It is essential to consult a healthcare provider if you experience any of these symptoms or if you have a heart murmur or develop other signs of mitral valve disease.
Risk Factors
Risk factors for developing mitral valve disease include older age, certain infections that can affect the heart, a history of heart conditions, high blood pressure, high cholesterol, diabetes, and other heart disease risk factors. Untreated strep infections, aging, and radiation therapy are also potential risk factors.
Development
Mitral valve disease can develop in two ways: congenitally or acquired. Congenital mitral valve disease is present at birth due to an abnormality in the valve structure. Acquired mitral valve disease occurs later in life and can be caused by various factors such as rheumatic fever, other heart conditions, infections, age-related changes, or autoimmune diseases like lupus.
Assessment and Diagnosis
Triage
You should see a doctor if you have chest pain, a fast, fluttering, or pounding heartbeat, or shortness of breath during activity, as these may be signs of mitral valve disease. If you have a heart murmur or other symptoms related to mitral valve disease, it's essential to consult a healthcare provider for further evaluation and treatment. In some cases, your provider may refer you to a specialist trained in heart diseases, such as a cardiologist.
Diagnosis
To diagnose mitral valve disease, including mitral valve stenosis and mitral valve regurgitation, a healthcare provider usually performs a physical exam and asks questions about your medical history. They will listen for a heart murmur, a sign of a mitral valve condition. Tests to diagnose mitral valve disease may include echocardiogram, electrocardiogram (ECG), chest X-ray, cardiac MRI, exercise tests or stress tests, and cardiac catheterization. The stage of heart valve disease is determined by considering symptoms, disease severity, valve structure, and blood flow through the heart and lungs.
Management and Treatment
Complications
Potential complications of mitral valve disease 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
- Stroke If left untreated or improperly treated, mitral valve disease can lead to these complications, which can further impact heart health and overall well-being. It's important to seek medical attention if you have signs or symptoms of mitral valve disease or if you've been diagnosed with the condition and are experiencing any concerning symptoms.
Prevention
Prevention of mitral valve disease is primarily focused on preventing rheumatic fever, as it is the most common cause of mitral valve stenosis. Rheumatic fever can develop from untreated streptococcal infections, such as strep throat. To prevent rheumatic fever, it is essential to seek prompt medical treatment for sore throats and other streptococcal infections with antibiotics. Ensuring proper care and timely treatment can help prevent the development of rheumatic fever and subsequent mitral valve disease.
Treatment
Treatment for mitral valve disease depends on the specific condition, its severity, and whether it is worsening. Treatment options may include:
- Medications: For some cases of mitral valve stenosis, medications may be prescribed to help manage symptoms and prevent further damage. These can include diuretics to reduce fluid buildup in the lungs, anticoagulants to prevent blood clots, and blood pressure-lowering medications.
- Monitoring: For some cases of mitral valve regurgitation, regular monitoring by a healthcare professional may be sufficient. This allows for early detection of any changes in the condition and the need for further treatment.
- Surgery: In some cases, surgery may be necessary to repair or replace the mitral valve. Mitral valve repair is often preferred when possible, as it preserves the patient's own valve. In severe cases or when repair is not feasible, valve replacement may be necessary. The specific treatment approach will depend on the individual case and should be discussed with a healthcare professional.
Preparing for medical consultation
To prepare for an appointment for mitral valve disease, follow these steps:
- Be aware of pre-appointment restrictions: When you make the appointment, ask if there's anything you need to do beforehand.
- Write down your symptoms, including any that seem unrelated to mitral valve disease.
- Write down key personal information, including a family history of heart disease, and any major stresses or recent life changes.
- Make a list of all medications, vitamins, and supplements you take.
- Take a family member or friend along, if possible, to help you remember information you receive.
- Be prepared to discuss your diet and exercise habits. If you don't already eat well and exercise, be ready to talk to your health care provider about challenges you might face in getting started.
- Write down questions to ask your health care provider. Some basic questions to ask include:
- What is likely causing my condition?
- What are other possible causes for my symptoms?
- What tests will I need?
- What's the best treatment? Remember to tailor your questions to your specific situation and concerns. Good luck with your appointment!