Mitral Valve Disease

The mitral valve separates the upper left chamber (left atrium) and the lower left chamber (left ventricle) of the heart. The mitral valve keeps blood flowing in the right direction — always from the atrium to the ventricle. A healthy mitral valve is an important part of the circulatory system. It ensures enough oxygenated blood moves into the left ventricle, which is the heart’s main pumping chamber, so the left ventricle can then move it into the aorta and out to the body.
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What is Mitral Valve Disease?

There are three main types of mitral valve disease:
  • Mitral valve stenosis
  • Mitral valve prolapse
  • Mitral valve regurgitation

Mitral Valve Stenosis

Mitral valve stenosis, or the tightening of the mitral valve, is a serious valve disease that can be caused by:
  • Calcium deposits
  • An infection that may cause scarring on the valve, such as lupus (an inflammatory disease that can affect skin, joints, kidneys, blood cells, heart, brain and/or lungs), rheumatic fever (an inflammatory disease that may develop after strep throat or scarlet fever) or endocarditis (an infection of the inner lining of the heart)
  • Radiation therapy

Mitral valve stenosis can also be a defect present at birth (congenital).

Mitral valve stenosis is a condition in which the valve’s leaflets (flaps) become stiff and hard, or even stuck together. If the leaflets aren’t flexible, they can’t open completely and the valve opening narrows. The heart must work harder to push blood through the narrower opening. This causes blood to back up into the lungs.

Untreated mitral valve stenosis may lead to:

  • Arrhythmia (irregular or abnormal heart beats)
  • Atrial fibrillation (an irregular and often fast heartbeat in the upper chambers of the heart, the atria)
  • Pulmonary hypertension (high blood pressure in your lungs and right side of your heart)
  • Congestive heart failure (a medical condition that occurs when the heart is not able to pump enough blood to the body)

Mitral Valve Prolapse

Sometimes one or both leaflets of the mitral valve have too much stretch to close properly. Instead of closing evenly, they bulge up into the atrium. This is called mitral valve prolapse. The bulging allows blood to leak back into the atrium, causing a murmur. This condition is most frequently present at birth (congenital), but it can also occur as the results of a connective tissue disease (a group of diseases that affect the tissue that connects various structures in the body), such as Ehlers-Danlos syndrome (a group of inherited disorders that affect connective tissue, primarily skin, joints and blood vessels) or Marfan syndrome (a genetic disorder of the connective tissue that may affect the eyes, skeleton and heart). Over time the leaking may increase and become mitral valve regurgitation.

Mitral Valve Regurgitation

Regurgitation or leaking occurs when the mitral valve’s leaflets don’t close tightly. When the valve doesn’t close completely, blood moves forward, but also leaks back into the atrium (the upper two chambers of the heart that move blood to the ventricles.) Mitral valve regurgitation limits the amount of blood that is pushed into the left ventricle and then out to rest of the body. It can lead to congestive heart failure (a medical condition that occurs when the heart is not able to pump enough blood to the body).

Leaking in the mitral valve can occur suddenly (acute) or develop over many years (chronic). It can occur due to:

  • Mitral valve prolapse (a condition in which the leaflets of the mitral valve balloon into the left atrium when the heart contracts. Also known as click-murmur syndrome, Barlow’s syndrome or floppy valve syndrome.)
  • A condition affecting the ventricle, such as heart failure (when the heart can’t pump as well as it should, limiting the amount of blood available to support the body’s functions), coronary artery disease or cardiomyopathy (diseases and abnormalities of the heart muscle)
  • Heart attack
  • An infection, such as rheumatic fever (an inflammatory disease that may develop after strep throat or scarlet fever) or endocarditis (an infection of the inner lining of the heart), which may damage the valve
  • Hypertrophic cardiomyopathy (a condition, often genetic, in which part of the heart muscle enlarges, making it difficult for the heart to pump blood efficiently).
  • Other diseases, such Marfan syndrome (a genetic disorder of the connective tissue that may affect the eyes, skeleton and heart), rheumatoid arthritis (an autoimmune disease that affects the joints), or lupus (an inflammatory disease that can affect skin, joints, kidneys, blood cells, heart, brain and/or lungs)
  • A defect in the valve that is present at birth (congenital)
As the condition worsens and your symptoms become more severe, the valve may need to be repaired or replaced. 

Symptoms