Mitral valve problems

Mitral Valve Prolapse (regurgitation):

In the small percentage of the population that does experience heart valve problems, by far the most common is Mitral valve prolapse. This condition is normally congenital and affects women more than men and is thought to affect about 6% of the female population.

The Mitral valve controls the flow of blood between the left Atrium and the left Ventricle. With Mitral valve prolapse the valve does not seal properly causing the valve to be pushed upward into the Atrium during the contraction of the ventricle.
In most cases the problem is not serious enough to cause any symptoms and often requires no treatment. In more severe cases, the improperly closed valve permits some blood to leak backward into the atrium. This condition is called Mitral valve regurgitation.

Such patients may experience some of the following symptoms:

• Heart racing or skipping a beat.
• Occasional chest pains.
• Shortness of breath.
• Anxiety or panic.
• Dizziness.

Mitral Stenosis: (problems opening)

This occurs when the Mitral valve is narrowed. This affects the opening of the valve thus restricting the flow of blood between your left atrium and left ventricle and hence to the rest of your body.

Most adults with Mitral stenosis will have had Rheumatic fever when they were younger which can cause scarring of the Mitral valve. Rheumatic fever is very uncommon in the developed world and thus Mitral stenosis is not often seen.

Depending on how serious the condition is, you may have any of the following symptoms:

• Fatigue, especially during times of increased activity.
• Shortness of breath, especially with exertion or when you lie down.
• Swollen feet or ankles.
• Heart palpitations.
• Frequent respiratory infections, such as bronchitis.
• Severe coughing, sometimes coughing up blood
• Occasionally chest discomfort.

Mitral Valve repair:

There are 2 main options for treating a damaged heart valve

1) Repair the valve: The idea behind this is to make your existing valve work better. There are various techniques your surgeon may use:

• Commissurotomy: Used on narrowed valves where the valve may have stuck together. Sometimes a scalpel is used to separate the valve other times a balloon catheter is used during angioplasty. The balloon is inflated opening up the valve.
• Decalcification: Calcium which builds up with age is removed from the valve.
• Valvuloplasty: This strengthens/tightens the valve by sewing a ring-like device around it.
• Reshaping: The surgeon reshapes the valve in such a way that it can close more tightly.
• Repair: Technique to add structural support to the valves so they can close properly.

2) Replace the Valve: The old valve is removed and replaced with one of 2 types of new valve:

• A prosthetic valve (man made): Usually made from metal or plastic and tend to last a long time. Patients who have these fitted will typically be on blood thinning medication for life
• Biological Valves: They are made from animal tissue or from a human donor. They don’t last as long as prosthetic valves, typically 10 years but patients do not normally require blood thinning medication.

‘This information is intended as a guide only and should not be used as a substitute for medical information from your own doctor’