Mitral valve disease

Diagnosis

A doctor would often conduct a physical examination and inquire about your medical history to identify mitral valve disease, which includes mitral valve stenosis and mitral valve regurgitation.

The doctor will listen for a heart murmur, which is a symptom of a mitral valve disorder.

Testing for mitral valve disease could involve:

• Echocardiogram. In order to create moving video images of the heart, sound waves are used. An echocardiogram gives a clearer picture of the mitral valve’s function. Used for diagnosis of congenital mitral valve disease, rheumatic mitral valve disease, and other heart valve diseases.

To view the mitral valve more closely, a transesophageal echocardiography may occasionally be performed. A tiny transducer attached to the end of a tube is placed down the tube going from the mouth to the stomach (esophagus) during this kind of echocardiogram.

• Electrocardiogram (ECG or EKG). Electrical signals from the heart are measured via wires (electrodes) connected to pads on the skin to identify heart disease, enlarged heart chambers, and abnormal rhythms of the heart.
• Chest X-ray. The health of the heart and lungs can be detected by a chest X-ray. It can show if the heart is enlarged, which may indicate a particular types of heart valve problems.
• Cardiac MRI. In order to assess the severity of mitral valve disease, a cardiac MRI may be performed. This examination produces fine pictures of the heart using radio waves and magnetic fields.
• Exercise tests or stress tests. These tests utilizes a treadmill or a stationary cycle while the heart rate is being tracked. Exercise tests can assist to determine how the heart reacts to exertion and whether signs of valve dysfunction manifest during exercise. If you are unable to exercise, you may be prescribed drugs that have effects on the heart similar to when you are doing exercise.
• Cardiac catheterization. A doctor inserts a thin tube (catheter) through a blood vessel in the arm or groin and inject dye into the catheter to improve the visibility of the cardiac arteries on an X-ray.

Although it is uncommon, cardiac catheterization can be performed to identify mitral valve disease or to check for the presence of coronary artery disease if other procedures have failed to detect it.

Your doctor might inform you of the disease stage if testing reveals that you have mitral or another type of heart valve disease.

The severity of the disease, the intensity of the symptoms, the structure of the valve or valves, and blood flow through the heart and lungs all affect the stage of heart valve disease.

Four stages of heart valve disease are distinguished as:

• Stage A: At risk. There are risk factors for heart valve disease.
• Stage B. Progressive. Mild to moderate valve disease. Heart valve symptoms are absent.
• Stage C. Asymptomatic severe. Heart valve disease is severe, although there are no symptoms.
• Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.

Treatment

Treatment for mitral valve disease is based on its severity, symptoms, and whether they are becoming worse or not.

Patients with mitral valve disease are normally looked after by a cardiologist with specialized training in mitral valve disease. The monitoring of the condition through routine follow-up visits may be part of the treatment for mitral valve disease. You might be suggested with the following if you have a mitral valve disease:

• Change your lifestyle for be healthier.
• Use medications to relieve symptoms
• Use blood thinners to lower your risk of blood clots if you have atrial fibrillation, a kind of irregular heart rhythm.

Surgery or other procedures

Both mitral valve replacement and repair are surgical options for treating mitral valve dysfunction. Even in the absence of symptoms, a diseased or damaged mitral valve may eventually require repair or replacement.

A surgeon might replace or repair your mitral valve at the same time as any other heart surgery you require if you have another heart issue.

Robot-assisted heart surgery, a sort of minimally invasive cardiac surgery in which robotic arms are employed to carry out the treatment, is carried out by surgeons at some medical facilities.

Mitral valve repair

The surgeon doing the mitral valve repair procedure might:

• Patch holes in a valve
• Reconnect the valve flaps
• Remove any extra tissue from the valve so that the flaps can firmly close
• Replace the cords that support the mitral valve to restore its structure.
• Separate fused valve leaflets

Other techniques for fixing the mitral valve include:

• Annuloplasty. A surgeon strengthens the ring surrounding the valve (annulus) by tightening it. Other procedures can be used in conjunction with annuloplasty to repair a heart valve.
• Valvuloplasty. A constricted mitral valve can be repaired using this catheter technique. Valvuloplasty may be performed even if you are asymptomatic. A catheter with a balloon on the tip is inserted by the surgeon into an artery in the arm or groin, and the catheter is then guided to the mitral valve. The mitral valve opening is made wider by the inflation of the balloon. The catheter and balloon are withdrawn when the balloon is deflated.
• Mitral valve clip. In this surgery, a surgeon threads a catheter with a clip on its end into an artery in the groin and into the mitral valve. The clip is used to repair a damaged or leaky leaflet of the mitral valve. People who have severe mitral valve regurgitation or who are not ideal candidates for mitral valve surgery may benefit from this therapy.

Mitral valve replacement

The mitral valve is removed during mitral valve replacement and replaced with a mechanical valve or a valve made of cow, pig, or human heart tissue (biological tissue valve).

Valve-in-valve operation is when cardiac catheter operation may be used to insert a replacement valve into a biological tissue valve that is no longer functioning correctly.

If your mitral valve was replaced with a mechanical valve, you will always need to take blood thinners to avoid blood clots. Over time, biological tissue valves degrade and typically need to be replaced.