Congenital mitral valve anomalies
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Congenital mitral valve anomalies are heart issues (congenital heart defects) affecting the valve between the upper left chamber of the heart (left atrium) and lower left chamber (left ventricle.)
The following conditions are mitral valve anomalies:
- Thick or stiff valve flaps (leaflets)
- Joined together leaflets (fused) or deformed leaflets
- Missing cords, short and thick cords, or cords attached to the heart muscle close to the mitral valve are all examples of issues with the cords that support the valve.
- Issues with the heart’s muscle or tissue close to the mitral valve
- Several openings in the part around the mitral valve (double-orifice valve)
Types of heart valve disease caused by mitral valve anomalies:
- Mitral valve stenosis (narrowing of the valve). Blood flow from the left atrium to the left ventricle is decreased by stiffening of the leaflets and constriction of the orifice of the mitral valve.
- Mitral valve regurgitation (leaky mitral valve). As your heart contracts, the mitral valve flaps either fail to seal completely or bulge backward (mitral valve prolapse) into the left atrium. The mitral valve therefore spills blood.
Both mitral valve stenosis and mitral valve regurgitation may occur at the same time.
Other congenital cardiac problems are frequently present in people with mitral valve abnormalities.
Symptoms
Some people don’t experience the warning signs or symptoms of congenital heart disease until they are adults. Years after a congenital heart disease has been fixed, symptoms may come back.
Typical adult congenital heart disease signs and symptoms include:
- Breathing difficulties
- Irregular heart sound (heart murmur)
- Irregular heart rhythms (arrhythmias)
- Fatigue
Seek immediate medical treatment if you experience any unsettling symptoms, such as chest pain or breathing difficulties.
Make an appointment to see your doctor if you have any of the signs or symptoms of congenital heart disease or if you had treatment for a congenital heart problem as a child.
Causes
One of the four heart valves that maintain proper blood flow is the mitral valve. Leaflets (flaps) on each valve open and close once with each heartbeat. Blood flow via the heart to the body may be diminished if a valve doesn’t open or close appropriately.
There are several reasons of mitral valve disease. Some types of mitral valve disease that can develop at birth (congenital heart defect).
Later in adulthood, mitral valve disease might also manifest (acquired). For instance, rheumatic fever frequently contributes to mitral valve stenosis. A strep infection that might harm the heart is the cause of this fever. This condition is known as rheumatic mitral valve disease.
Acquired mitral valve disease can also result from:
- Having an autoimmune disease (e.g., lupus)
- Infection
- Changes related to age
- Other heart diseases
Risk factors
The following factors can raise the risk of mitral valve disease:
- Being old
- Some heart-related infections
- Certain heart disease and heart attack
- Taking some medications
- Congenital heart condition
- Exposure of the chest to radiation
Diagnosis
The doctor will perform a physical examination and inquire about your signs and symptoms, medical history, and family history. A heart murmur, which may be an indication of mitral valve disease, will be heard by your doctor as they listen to your heart with a stethoscope.
The primary examination for identifying congenital mitral valve anomalies is an echocardiography. Sound waves produce moving video images of your heart during an echocardiography which displays the heart’s structure, heart valves, and blood flow.
The echocardiogram comes in two varieties. A transducer (device) is pressed firmly against your skin during a typical (transthoracic) echocardiogram so that the technician may direct an ultrasound beam through your chest to your heart. The transducer captures the echo of your heartbeat on tape. The echoes are transformed into animated pictures by a computer.
You could require a transesophageal echocardiography if your doctor feels that a normal echocardiogram does not provide enough information. A flexible probe with a transducer is inserted through the throat then down into the esophagus.
Further tests may be performed such as a chest X-ray or Electrocardiogram (ECG or EKG).
Treatment
The signs, symptoms, and severity will determine the treatment for congenital mitral valve anomalies. Routine checkups are important to manage your health.
The mitral valve may eventually require surgical repair or replacement.
Mitral valve repair
When a mitral valve repair is an option, your doctor may advise to preserve your heart valve. During mitral valve repair, surgeons may perform any one or more of the following:
- Patch holes in a valve
- Reconnect valve flaps
- Separate fused valve flaps
- Separate, remove or reshape muscle near the valve
- Separate, lengthen, shorten, or replace the cords holding the valve.
- Cut away any extra valve tissue to allow the leaflets to firmly seal.
- Use an artificial ring to tighten or strengthen the ring surrounding a valve (annulus).
Mitral valve replacement
Your doctor might advise mitral valve replacement if the mitral valve cannot be fixed. The diseased mitral valve is removed during mitral valve replacement, and either a mechanical valve or a valve composed of cow, pig, or human heart tissue (biological tissue valve) is used in its replacement.
Biological tissue valves inevitably require replacement as they deteriorate over time. You will require lifelong blood-thinning medicine if you have a mechanical valve in order to prevent blood clots. Your doctor will go over the advantages and disadvantages of each type of valve with you and help you decide which one is best for you.
Both mechanical and biological tissue valves may be utilized in both children and adults. After weighing the risks and benefits, the cardiologist, surgeon, and family decide on the precise valve to be utilized.
Follow-up care
Medical professionals with specialized training in congenital heart disorders, such as pediatric and adult congenital cardiologists, must offer lifetime care for children and adults who have undergone surgery for congenital mitral valve anomalies or who have such anomalies. Both adults and children will require routine follow-up visits to check for any changes in their conditions. To replace a valve that is no longer functional, patients might require additional surgeries or valve repairs.
