Medical Management for Mitral Valve Disease
In general, there are two forms of mitral valve disease: mitral stenosis and mitral regurgitation/insufficiency (including mitral valve prolapse).
Mitral Stenosis (Valve Does not Open Fully)
Mitral stenosis is a disabling and eventually lethal mechanical disorder of the mitral valve caused by an inability of the valve leaflets (flap-like structure that control the one way flow of blood in the heart) to open fully. Over time, the heart weakens as it struggles to get blood through a small, tight valve opening.
For some, the primary and often only symptom of mitral stenosis is shortness of breath. However, untreated progressive disease can lead to significant symptoms (shortness of breath and fatigue) and serious complications such as pulmonary edema (fluid on the lungs), formation of blood clots within the body, and pulmonary hypertension (high blood pressure in the lungs). The majority of cases of mitral stenosis are related to the buildup of scar tissue on the valves due to rheumatic heart disease. Symptoms usually appear 16 to 40 years after the episode of acute rheumatic fever.
Medical Management for Mitral Stenosis
Although medical management (medications) can relieve symptoms associated with mitral valve stenosis, it cannot prevent the progression of mitral valve disease. Depending upon individual symptoms, a variety of medications may be used to treat patients with mitral stenosis. Examples of the types of medications are diuretics (promote urination), Digoxin, beta blockers (slow the heart rate and reduce the heart's force of contraction) and blood thinners such as aspirin or Warfarin.
Mitral Regurgitation/insufficiency (Valve Does not Close Tightly)
In mitral regurgitation/insufficiency, the valve leaflets (flap-like structure that control the one way flow of blood in the heart) do not close completely. This causes the blood to flow backwards (leak) from the left ventricle (main pumping chamber of the heart) to the left atrium (upper chamber of the heart). The abnormal blood flow increases stress on the heart. The typical symptoms of mitral regurgitation/insufficiency are exercise intolerance, shortness of breath and fatigue.
Medical Management for Mitral Regurgitation/insufficiency
Medical management for mitral regurgitation/insufficiency has a limited role and is to improve the forward flow of blood and decrease the amount of blood flowing backwards through the valve. Mitral regurgitation/insufficiency is similar to mitral stenosis in that medical management (medications) can relieve symptoms associated with regurgitation/insufficiency, but cannot prevent the progression of mitral valve disease. The cardiologist will determine what medications will work best for each individual patient's symptoms.
For more information regarding mitral valve disease and the treatments available, please contact the Bluhm Cardiovascular Institute at 1-866-662-8467 or request a first time appointment online.