Overview of Mitral Valve Disease

Mitral valve disease relates to conditions affecting the mitral valve.  The mitral valve is located between the upper and lower left heart chambers, allowing blood to flow forward.  It allows the blood to flow from the left atrium into the left ventricle, preventing blood to back up into the lungs.

The different diseases that affect the valve will result in gradual or sudden deterioration of the valve resulting in either a “leakage” or regurgitation (most common) or “blockage” (stenosis) affecting the normal flow with backflow into the lungs resulting in difficulty breathing and not enough blood going into the main stream that causes fatigue. Many people don’t experience symptoms for years, however, more commonly symptoms develop and progress into congestive heart failure, irregular heart beat (atrial fibrillation), high pressures in the pulmonary circulation (pulmonary hypertension) and secondary “leakage” of the tricuspid valve. If left untreated, mitral valve disease can be serious and life threatening.

mitral valve diagram

Most common causes of mitral valve disease resulting in regurgitation or stenosis:

Valve regurgitation:

  • Mitral valve prolapse (degenerative)
  • Heart attack or coronary disease (Ischemic)
  • Valve infection (endocarditis)
  • Inflammation /strep infection in childhood (Rheumatic)

Valve stenosis:

  • Inflammation/strep infection in childhood (Rheumatic)
  • Calcification
  • Tumors

Type of symptoms in mitral valve disease develop gradually and can be subtle. When the symptoms develop, they include:

  • Shortness of breath (gets worse when lying down or on effort)
  • Fatigue and tiredness
  • Swelling in the ankles
  • Cough
  • Palpitations (irregular heart beat)

Mitral valve disease is diagnosed by clinical suspicion of your examining physician. He or she will listen to your symptoms description and to your heart with the stethoscope. Different types, location and intensity of murmurs will lead to a suspicion of a mitral problem. Then, it will be confirmed by tests such as echocardiograms (ultrasound), X-rays and cardiac catheterization (dye test to check coronary arteries).

Medical treatment is always the first step, but if the degree of mitral valve disease is severe and symptoms are present, then surgical evaluation is needed to address the need of a mitral valve repair or replacement.