Overview

In mitral valve disease, the mitral valve, which is located between your left heart chambers (left atrium and left ventricle), doesn't work properly.

Types of mitral valve disease include:

Mitral valve regurgitation

In this condition, the flaps (leaflets) of the mitral valve don't close tightly, causing blood to leak backward into the left atrium of your heart. If not treated, it can result in heart muscle damage.

This condition is commonly caused by mitral valve prolapse, in which the leaflets bulge back into the left atrium as your heart contracts.

Mitral valve stenosis

In this condition, the flaps of the mitral valve become thick or stiff, and they may fuse together. This results in a narrowed valve opening and reduced blood flow from the left atrium to the left ventricle.

Treatment for mitral valve disease depends on the severity of your condition and whether your condition is becoming worse. Your doctor may eventually recommend that you have surgery to repair or replace your mitral valve.

Mitral valve disease care at Mayo Clinic

Symptoms

Some people with mitral valve disease might not experience symptoms for many years. Signs and symptoms of mitral valve disease may include:

  • Abnormal heart sound (heart murmur) heard through a stethoscope
  • Fatigue
  • Shortness of breath, particularly when you have been very active or when you lie down
  • Swelling of your ankles and feet
  • Irregular heartbeat

When to see a doctor

If you have a heart murmur, your doctor may recommend that you visit a cardiologist. If you develop any symptoms that may suggest mitral valve disease, see your doctor.

Causes

Your heart has four valves that keep blood flowing in the correct direction. These valves include the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps (leaflets or cusps) that open and close once during each heartbeat. Sometimes, the valves don't open or close properly, disrupting the blood flow through your heart to your body.

In mitral valve disease, the mitral valve between the upper left heart chamber (left atrium) and the lower left heart chamber (left ventricle) doesn't work properly. It may not be closing properly, which causes blood to leak backward to the left atrium (regurgitation), or the valve may be narrowed (stenosis).

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

Mitral valve regurgitation can be caused by problems with the mitral valve, also called primary mitral valve regurgitation. Mitral valve regurgitation is often caused by mitral valve prolapse, in which the mitral valve flaps (leaflets) bulge back into the left atrium. Diseases of the left ventricle can lead to secondary mitral valve regurgitation.

Mitral valve stenosis is often caused by rheumatic fever, which is a complication of a strep infection that can affect the heart.

Risk factors

Several factors can increase your risk of mitral valve disease, including:

  • Older age
  • History of certain infections that can affect the heart
  • History of certain forms of heart disease or heart attack
  • History of use of certain drugs
  • Heart conditions present at birth (congenital heart disease)

Complications

Mitral valve disease can cause many complications, including:

  • Irregular heart rhythms in the upper heart chambers (atrial fibrillation)
  • High blood pressure that affects the blood vessels in the lungs (pulmonary hypertension)
  • Blood clots
  • Heart failure
  • Stroke

Mitral valve disease care at Mayo Clinic

March 03, 2017
References
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  2. Mitral stenosis. Merck Manual Professional Version. http://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/mitral-stenosis. Accessed Sept. 22, 2016.
  3. What is heart valve disease? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hvd. Accessed Sept. 20, 2016.
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  5. Getting support. American Heart Association. http://www.heart.org/HEARTORG/Caregiver/ReachOut/GettingSupport/Getting-Support_UCM_301847_Article.jsp#.WCn5QdgzXIU. Accessed Nov. 4, 2016.
  6. How can I make my lifestyle healthier? American Heart Association. http://www.heart.org/HEARTORG/Conditions/More/ToolsForYourHeartHealth/Answers-by-Heart-Fact-Sheets-Lifestyle-and-Risk-Reduction_UCM_300611_Article.jsp#.WC9socnFjVY. Accessed Nov. 18, 2016.
  7. Nishimura RA, et al. Mitral valve disease — Current management and future challenges. Lancet. 2016;387:1324.
  8. Ruiz CE, et al. Transcatheter therapies for the treatment of valvular and paravalvular regurgitation in acquired and congenital valvular heart disease. Journal of the American College of Cardiology. 2015;66:169.
  9. Nishimura RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. The Journal of Thoracic and Cardiovascular Surgery. 2014;148:e1.
  10. AskMayoExpert. Mitral regurgitation. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  11. Riggin ER. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Aug. 12, 2016.
  12. Taggarse AK, et al. How has robotic repair changed the landscape of mitral valve surgery? Annals of Cardiothoracic Surgery. 2015;4:358.
  13. Daniels BK. Echo Information Management System. Mayo Clinic, Rochester, Minn. Oct 18, 2016.

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