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Mitral Valve Disease

Mitral valve diseases are lifelong conditions that make it hard for you to breathe, especially during physical activity. At the Center for Structural Heart Disease at Henry Ford Hospital, our heart specialists are experts in treating all types of heart valve diseases. We bring together our expertise from several heart specialties to help you achieve your best health.

The mitral heart valve

In your heart, 4 valves control blood flow through the heart’s chambers, sending blood and oxygen to the rest of the body. As blood passes through the chambers on the left side of the heart, it flows from the left atrium (upper chamber) through the mitral valve into the left ventricle (lower chamber). The mitral valve controls the flow of oxygen-rich blood coming from the lungs through the left side of the heart before it is pumped to the body.

In a normal mitral valve, 2 flaps (leaflets) open to allow blood to flow from the left atrium to the left ventricle. The leaflets then close to form a tight seal to prevent blood from leaking back into the left atrium.

What is mitral valve disease?

Mitral valve disease develops when the mitral valve does not open or close properly. The three types of mitral valve disease are:

  • Mitral stenosis

    In this condition, the leaflets become thick and stiff so that the valve does not fully open. The narrowed opening (stenosis) reduces blood flow from the lungs through the heart to the rest of the body. Blood remains in the left atrium and backs up into the lungs, causing pressure and fluid buildup.

  • Mitral regurgitation

    This condition is the most common type of heart valve disorder. It occurs when the leaflets of the mitral valve do not completely close, allowing blood to leak backward from the left ventricle into the left atrium. Some blood flows forward into the left ventricle and then out to the body. The reduced flow of blood and oxygen to the body causes the heart to beat harder.

  • Mitral prolapse

    Similar to mitral regurgitation, mitral prolapse involves improper closing of the valve’s leaflets. In this condition, one or both leaflets flop (prolapse) back into the left atrium, preventing the valve from closing tightly. Although mitral valve prolapse can lead to mitral regurgitation, most people with prolapse do not develop regurgitation.

    In all three mitral valve diseases, the heart must pump harder to send oxygen-rich blood to the body. The additional pressure and fluid buildup can cause shortness of breath, chest pain and other symptoms of heart failure. Download our PDF on mitral stenosis to learn more.

Causes of mitral valve disease

Mitral valve disease can either be present at birth or develop later in life.

Congenital mitral valve disease

In this type, people are born with a mitral valve that is narrowed. Or, they may have other birth defects that can lead to mitral stenosis. Medical experts do not know the exact cause of congenital mitral valve disease.

Acquired mitral valve disease

The acquired type develops later in life because of infection or other factors that damage the mitral valve, including:

  • Rheumatic fever: Strep throat, if left untreated, can lead to rheumatic fever. As the body fights off the infection, inflammation can damage the mitral valve. Mitral valve disease that develops as a result of this infection can take years to appear.
  • Calcification: Calcium can build up on the leaflets, causing the valve to stiffen and thicken.
  • Heart conditions: Endocarditis (infection inside the heart), heart attack or other heart diseases cause damage or scarring that can lead to mitral stenosis or regurgitation.

If you develop strep throat, see your physician for proper care, including a full course of antibiotics, to prevent rheumatic fever. Your physician may recommend an echocardiogram (heart ultrasound) every 1 to 2 years if you have had rheumatic fever to check for heart problems.

Symptoms of mitral valve disease

Mitral valve disease progresses slowly. You may have mild or no symptoms in the early stages. As the mitral valve deteriorates over time, you may experience symptoms that often worsen during

physical activity or when lying down, including:

  • Chest pain (rare)
  • Difficulty breathing during or after exercise (most common)
  • Fainting (syncope) and dizziness
  • Fatigue and tiring quickly
  • Heart murmur
  • Heart palpitations (sensation of racing, fluttering or pounding heartbeat)
  • Heavy coughing, sometimes with bloody phlegm
  • Irregular heartbeat (arrhythmia)
  • Shortness of breath, especially during exertion or while lying down
  • Swollen ankles or feet

Diagnosing mitral valve disease

At Henry Ford, our structural heart specialists work quickly to understand your symptoms so we can get you the help you need. We begin our diagnostic process with a thorough evaluation, whether or not you already have a diagnosis.

During your first visit, we meet with you to:

  • Perform a complete physical exam
  • Review your medical history
  • Discuss your symptoms and lifestyle
  • Review any previous tests or imaging studies

Depending on your symptoms, overall health and previous test results, we may recommend further testing for additional information to help us plan your treatment. Read about the advanced technology we use for diagnosis of mitral valve diseases.