Mitral valve disease

Overview

Mitral valve disease is a problem with the valve located between the left heart chambers (left atrium and left ventricle).

Mitral valve disease includes:

• Mitral valve regurgitation. The mitral valve flaps (leaflets) may not close tightly, causing blood to leak backward.
• Mitral valve stenosis. The flaps of the mitral valve become thick or stiff, and they can fuse together. This narrows the valve opening, which reduces blood flow from the left atrium to the left ventricle.

Treatment for mitral valve disease depends on the severity of the condition and whether it is worsening. Sometimes, surgery is recommended to repair or replace the mitral valve.

Types

Symptoms

Some people with mitral valve disease might not have symptoms for many years, if at all.

Signs and symptoms of mitral valve disease can include:

• Fatigue
• Irregular heart sound (heart murmur)
• Irregular heartbeat
• Shortness of breath

When to see a doctor

If you have a heart murmur or develop other signs or symptoms of mitral valve disease, your health care provider might recommend that you visit a doctor that specializes in heart diseases (cardiologist).

Causes

To understand the causes of mitral valve disease, it may be helpful to know how the heart works.

The mitral valve is one of four valves in the heart that keep blood flowing in the right direction. Each valve has flaps (leaflets) that open and close once during each heartbeat. If a valve doesn't open or close properly, blood flow through the heart to the body can be reduced.

In mitral valve regurgitation, the flaps don't close tightly. Blood flows backward when the valve is closed, making it harder for the heart to work properly.

In mitral valve stenosis, the valve opening narrows. The heart now must work harder to force blood through the smaller valve opening. If the opening in the valve becomes small enough, it can reduce blood flow from the left atrium to the left ventricle.

Mitral valve disease has many causes. Some forms of mitral valve disease can be present at birth (congenital heart defect).

Mitral valve disease may also develop later in life (acquired). For example, mitral valve stenosis is often caused by rheumatic fever. This fever is a complication of a strep infection that can affect the heart. When this happens, it's called rheumatic mitral valve disease.

Other causes of acquired mitral valve disease include:

• Other heart conditions
• Infection
• Age-related changes
• Autoimmune disease, such as lupus

Risk factors

Several things can increase the risk of mitral valve disease, including:

• Older age
• Certain infections that affect the heart
• Heart attack and some types of heart disease
• Use of certain drugs
• Heart condition present at birth (congenital heart defect)
• Radiation to the chest

Complications

Mitral valve disease can cause many complications. Severe mitral valve regurgitation, for example, causes the heart to work harder, which can cause the left ventricle to enlarge and the heart muscle to weaken.

Other complications of mitral valve disease may 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