Definition

Mitral valve disease can develop if the mitral valve that is located between the left atrium and left ventricle (left heart chambers) doesn’t function well.

There are two types of mitral valve disease, including mitral valve regurgitation and mitral valve stenosis.

Mitral valve regurgitation occurs when flaps of the mitral valve are not closing firmly, which allows blood to leak backwards into the left atrium of the heart. As a result, blood doesn’t move efficiently through the heart and the rest of the body causing fatigue and shortness of breath. If this condition is not treated it may lead to damage of the heart muscle. The usual cause for the blood to leak is mitral valve prolapse.

Mitral valve stenosis is narrowing of the mitral valve. It occurs when the flaps of the mitral valve are thick and stiff and can merge together leading to narrow, improper opening of the valve that stops the blood flow to the left ventricle (the main pumping chamber of the heart). Thus the blood flow from one to the other left heart chambers i.e. from the left atrium to the left ventricle is reduced.

 

Symptoms of mitral valve stenosis

Although symptoms of mitral valve stenosis can occur at any age, they most usually occur in people at the age between 30 and 50.

The symptoms can appear or become worse when the heart rate increases, as it can happen during exercising for example.

The pressure that gathers in the heart is sent back to the lungs, which results in congestion and shortness of breath.

The most common symptoms of mitral valve stenosis are:

  • Weakness
  • Fatigue
  • Shortness of breath

Rapid heartbeat may appear alongside these symptoms.

A person with mitral valve stenosis can feel well, or experience only minor symptoms for decades.

The minor symptoms can occasionally become worse when least expected. If some of the following (listed below) symptoms are experienced, it is important to visit the doctor:

  • Shortness of breath (even when lying down)
  • Feeling weak and tired
  • Dizziness
  • Fainting
  • Swollen legs and feet
  • Heavy coughing
  • Discomfort and pain in the chest
  • Rapid and fluttering heartbeat
  • Severe headache
  • Having troubles to speak

When examined at the doctors, a person with mitral valve stenosis can also have: heart murmur, arrhythmias, or buildup of fluid in the lungs.

 

Cause of mitral valve stenosis

The most common cause of mitral valve stenosis is rheumatic fever that can damage the mitral valve. It causes the valve to thicken and fuse, which can result in scarring. Rheumatic fever is related to strep infections. It is rare nowadays, but there are still some cases diagnosed in developing countries.

Other causes of mitral valve stenosis can be:

  • Calcium deposits that can build up around the annulus with aging
  • Narrowed mitral valve: Congenital defect that appears in newborns

 

Risk factors of mitral valve stenosis

Risk factors for mitral valve stenosis can be:

  • Having a history of rheumatic fever
  • Strep infections that are left untreated

 

Complications of mitral valve stenosis

Similarly to other heart valve problems, mitral valve stenosis can also decrease the blood flow and strain the heart. If the condition is left untreated it can result in serious complications such as:

  • Heart failure
  • Heart enlargement
  • Pulmonary hypertension
  • Blood clots
  • Atrial fibrillation
  • Lung congestion

 

 

Treatment

 

Treatment of mitral valve stenosis

Mild to moderate cases of mitral valve stenosis that do not cause symptoms, usually don’t require treatment, but rather regular monitoring to check for possible worsening of the condition.

In more severe cases, treatment options can be medications, nonsurgical and surgical procedures.

There are no drugs that can repair the condition of mitral valve stenosis, but there are certain drugs that can help ease the heart workload, regulate its rhythm and reduce the symptoms. Some of these drugs can be: diuretics, anticoagulants, beta blockers or calcium channel blockers, anti-arrhytmics and antibiotic that prevent rheumatic fever to reoccur.

Surgical and nonsurgical procedures to repair or replace the valve may be another option to treat mitral valve stenosis. Nonsurgical procedure that is often used to repair the valve is balloon valvuloplasty. In some cases, this procedure can equally relieve the symptoms as a surgery. If the condition worsens again, the procedure can be repeated. However, not every person with mitral valve stenosis is a good candidate for this procedure, so the patient should discuss the options with a doctor. Surgical procedures that can be done for mitral valve treatment can be commissurotomy during which calcium deposits and scarred tissue are removed or mitral valve replacement, during which the narrowed valve is removed and replaced with mechanical or tissue valve.

Treatment for mitral valve regurgitation

The treatment for mitral valve regurgitation will differ depending on few things such as:

·         Severity of the condition

·         The progression of the condition

·         Present symptoms

Usually, for mild cases, or when the leakage is mild, treatment is not needed. However, if the leakage is severe, the patient will probably need a heart surgery during which the valve will be repaired or replaced.

 

A person having mitral valve disease should consider improving the life quality by taking into consideration some or the following advices:

·         Taking good care of the teeth and visiting the dentist regularly

·         Limiting salt in the food

·         Maintaining healthy weight

·         Exercising

·         Reduce caffeine intake

·         Reduce drinking alcohol

·         visit the doctor for regular check-ups

 

Prevention of mitral valve stenosis

The easiest possible way to prevent mitral valve stenosis is to prevent rheumatic fever which is the most common cause of the condition. Visit the doctor when experiencing sore throat because if strep throat infections are left untreated they can lead to rheumatic fever. Fortunately, strep throat infections can be easily treated with antibiotics.