Mitral valve diseases, The mitral (bicuspid) valve is one of the four main heart valves. It is also called the mitral valve and plays a vital role in properly directing blood flow from the left atrium to the left ventricle. However, in some cases, there may be an inability to function properly, such as a narrowing of the mitral valve, which forces the heart to work harder to pump blood to the rest of the body. So, in this article, we will learn about these problems and the appropriate ways to treat them.
Mitral valve diseases
Mitral valve disease occurs when the valve doesn’t work properly, allowing blood to flow back into the left atrium. As a result, your heart doesn’t pump enough blood from the left ventricular chamber to provide your body with oxygen-filled blood, causing symptoms such as fatigue and shortness of breath.
Types of mitral valve diseases
There are three main types of mitral valve disease, including:
Mitral valve prolapse
Mitral valve prolapse (MVP) occurs when the mitral valve is very flexible, which causes it to close completely during systole, but it extends into the left atrium like an inflated balloon. When the ventricle relaxes, the valve opens so that blood passes from the left atrium to the left ventricle. Over time, it may Valve prolapse develops into valve regurgitation, which is why it is always recommended for patients with mitral valve prolapse to follow up periodically with a cardiologist to properly deal with the condition.
Mitral valve regurgitation
Some blood flows in the wrong way in the heart because the mitral valve does not close properly and leads to increased blood flow to the lung and may lead to filtration in the lung, which explains the complaint of difficulty breathing and gasping with minimal effort in patients with mitral valve regurgitation.
Mitral valve disease affects more than 2% of the population, making it the most common valve disease worldwide.
If treatment is neglected, this may cause several heart problems, such as: irregular heartbeat, high pulmonary artery pressure, and enlarged heart muscle, and may lead to heart weakness or failure.
Mitral valve stenosis
MVS occurs when the mitral valve does not open fully as it should, restricting blood flow through the heart.
Causes of mitral valve disease
The causes of mitral valve disease vary according to each type, and are as follows:
Causes of mitral valve prolapse
It is a lifelong disorder and women are twice as likely to develop the disease as men, but the condition can develop at any age. Mitral valve prolapse can run in families as an inherited cardiovascular disease and may be associated with several other conditions, such as:
Marfan syndrome, Ehlers-Danlos syndrome, Graves’ disease and scoliosis.
The causes of mitral valve prolapse are as follows:
1- Mitral valve prolapse usually occurs due to problems in the tissues that connect it to the heart muscles.
2- Some people are born with this condition, and it is more common in people who suffer from connective tissue disorders, such as: Marfan syndrome.
3- In rare cases, it can occur due to damage to the heart muscles themselves as a result of a heart attack.
Causes of mitral valve regurgitation
There are a variety of heart problems that can cause mitral valve regurgitation, including the following:
- heart attack.
- Rheumatic fever.
- Endocarditis, or inflammation of the lining of the heart and valves.
Causes of mitral valve stenosis
MVS is usually caused by rheumatic fever, which is a serious complication of strep throat or scarlet fever. The heart and joints are among the organs most affected by acute rheumatic fever.
Different parts of the heart can also become inflamed, causing some potentially serious heart disease, including:
- Myocarditis.
- Inflammation of the lining of the heart (endocarditis).
- Inflammation of the membrane surrounding the heart (pericarditis).
Symptoms of mitral valve disease
Symptoms of different mitral valve diseases vary, and are as follows:
Symptoms of mitral valve prolapse
A person with MVP may have no symptoms, and it is only discovered during a heart examination (echocardiogram) performed for another reason.
Mitral valve prolapse can sometimes cause:
- Dizziness and fatigue.
- shortness of breath.
- Arrhythmia.
Symptoms of mitral valve regurgitation
The degrees of mitral valve regurgitation are divided into 4 stages: mild, moderate, above-moderate, and severe. Mild chronic mitral valve regurgitation may not cause any symptoms in the initial stages. However, if it becomes more severe, a person may begin to feel some symptoms, such as:
- exhaustion.
- Heart palpitations.
- Decreased ability to exercise.
- Swelling in the abdomen, legs and neck veins.
- Shortness of breath during physical exertion or when lying down.
Severe acute mitral valve regurgitation is a medical emergency that can cause the following symptoms:
- Severe shortness of breath.
- Severe chest pain.
- Sometimes heart failure.
Symptoms of mitral valve stenosis
Some common symptoms of MVS include:
- exhaustion.
- Dizziness.
- pain in chest.
- Heart palpitations or irregular heartbeat.
- Shortness of breath, especially when exercising or lying down.
Diagnosis of mitral valve diseases
If Dr. Mohamed Al-Ghannam suspects you may have mitral valve disease, he will examine your heart using a stethoscope, as unusual sounds or rhythm patterns may help him make an initial diagnosis.
He may also order some additional tests to help confirm the diagnosis of mitral valve disease, such as:
- Sound waves on the heart, known as echo, accurately determine mitral valve disease and the degree of valve damage, as well as the efficiency of the heart muscle and the amount of expansion in the four chambers of the heart, if any.
- Cardiac catheterization: This procedure allows your doctor to perform a variety of tests, including getting an image of the blood vessels in your heart.
- Electrocardiogram (ECG): This test records the electrical activity of your heart.
- Holter monitoring: This is a portable monitor that records the electrical activity of your heart over a period of time, usually 24 to 48 hours.
- Tests to monitor heart activity
Treatment of mitral valve diseases
Mitral valve diseases can be treated, according to the nature and symptoms of each disease, as follows:
Treatment of mitral valve prolapse
Patients may not need treatment if they do not have symptoms, and Dr. Muhammad Al-Ghannam may suggest that they make some lifestyle changes, such as quitting smoking and caffeine, as these things make the heart work very hard, and some regular tests should be performed to monitor and follow up on the condition.
If there are clear symptoms or the mitral valve is very flexible, the doctor may recommend the following:
- Some medications to relieve symptoms, such as: beta blockers to treat irregular heartbeat.
- Mitral valve surgery: with the aim of repairing or replacing the mitral valve.
Treatment of mitral valve regurgitation
Treatment depends on the symptoms the patient is experiencing, the condition that caused the mitral valve regurgitation, how well the heart is working, and whether the heart has become enlarged.
Some medications may be prescribed when symptoms worsen, such as:
- Diuretics that help reduce fluid accumulation in the body and swelling of the legs and feet.
- Blood thinners to prevent blood clots.
- Beta blockers that help control heart rate.
- High blood pressure medications to keep blood pressure stable.
The patient may need to undergo some surgical procedures to repair or replace the valve, in the following cases:
- Poor heart function.
- Heart enlargement.
- Worsening of symptoms.
One of the following surgical interventions may be used:
- Open heart surgery, to repair or replace the mitral valve.
- Minimally invasive surgery in which the mitral valve is repaired or replaced from a small incision between the ribs without the need for traditional bone opening.
Treatment of mitral valve stenosis
You may not need treatment if you do not have any symptoms. Dr. Muhammad Al-Ghannam may suggest some regular checkups to monitor your condition.
If you have symptoms or your valve problem is serious, he or she may recommend:
- Medication to relieve symptoms, such as diuretics.
- Mitral valve surgery, to replace the valve or perform balloon catheter valve dilatation.
In conclusion, it can be said that mitral valve diseases occur due to a defect in the functioning of the valve, which affects the pumping of blood and the heart’s performance of its vital functions, causing serious symptoms. Therefore, care must be taken to adhere to a healthy lifestyle and follow up periodically by visiting Dr. Muhammad Al-Ghannam, professor and consultant of open-heart surgery, as early diagnosis and appropriate treatment help heart patients avoid any complications, God forbid.
