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 - Northwestern Memorial Hospital - Chicago

Mitral Valve Regurgitation, Stenosis & Prolapse

The mitral valve is referred to as atrioventricular valves because it is located between the left atria and the left ventricle. The mitral valve regulates the flow of oxygen rich blood from the lungs to pass from the left atrium to the left ventricle.

There are two main diseases or malfunctions of heart valves: regurgitation (valve does not close tightly) and stenosis (valve does not open fully). Regurgitation and stenosis disrupt the heart cycle because the heart valves fail to open and close properly resulting in improper blood flow through the heart. The mitral valve is also prone to a disease referred to as mitral valve prolapse. With mitral valve prolapse, the mitral valve bulges slightly back into the left atrium when it closes, allowing a small amount of blood to leak backward.

Mitral Valve Insufficiency/Regurgitation

  • Overview: Mitral valve insufficiency/regurgitation is a disease in which the mitral valve does not close completely, causing blood to flow backward instead of forward through the valve. Mitral valve insufficiency/regurgitation may develop in response to a number of conditions.
     
  • Signs and Symptoms: The primary symptoms are shortness of breath, fatigue, palpitations and, on occasion, chest pain.
  • Causes: Common causes of mitral valve insufficiency/regurgitation include rheumatic fever, mitral valve prolapse, mitral annulus calcification, infective endocarditis (an infection that affects the lining of the heart's chambers and the heart valves), congenital causes, a weakened heart muscle caused by a heart attack, rheumatic heart disease, infections of the heart valve, and weakness of the heart muscle that has dilated due to primary heart muscle disease.
  • Risk Factors: The risk factors for mitral valve insufficiency are still being determined. There is a hereditary component in patients with floppy mitral valve under the age of 40 years.
  • Diagnosis - Screening/Tests: An echocardiogram is a non-invasive test that uses high-frequency sound waves to create a moving picture of the heart chambers, the heart valves, and major blood vessels located near the heart.
  • Complications: Patients may develop endocarditis if antibiotics are not given prior to dental appointments. If the mitral regurgitation is severe and symptoms are present, progressive heart failure can develop.
  • Treatment: Surgical valve repair is the treatment of choice in a surgical center that performs a high volume of mitral valve repair procedures.
  • Prevention: There is no treatment to prevent the development of mitral regurgitation. Once mitral regurgitation is present, it is best to treat the underlying cause of the mitral regurgitation.

Mitral Valve Stenosis

  • Overview: Mitral valve stenosis is a disease in which the mitral valve opening does not open wide enough, inhibiting the ability of the heart to pump blood to the body due to the increased force required to pump blood through the stenotic (stiff) valve.
     
  • Signs and Symptoms: The primary symptoms are fatigue and shortness of breath. As the disease progresses, the breathlessness can progress. Also, cough, palpitations (an unusual awareness of the heartbeat) and, as the symptoms progress, chest pain can develop.
  • Causes: The most common cause of mitral stenosis is rheumatic fever (inflammatory disease that may develop after an infection with streptococcus bacteria—such as strep throat or scarlet fever). It usually takes two or more years after the rheumatic episode for the development of the stenotic (thickened) valve. However, most patients do not have symptoms for 15-20 years after an episode of rheumatic fever.
  • Risk Factors: The major risk factor is exposure to streptococcal infection that is not diagnosed.
  • Diagnosis - Screening/Tests: An echocardiogram is a non-invasive test that uses high-frequency sound waves to create a moving picture of the heart chambers, the heart valves, and major blood vessels located near the heart.
  • Complications: Complications include endocarditis (an infection that affects the lining of the heart's chambers and the heart valves).
  • Treatment: Treatment options include the administration of antibiotics prior to dental procedures and beta-blockers and diuretics if heart failure develops.
  • Prevention: Primary prevention (prevention before the disease develops) includes the adequate treatment of strep (streptococcus) throat infections. Secondary prevention (prevention of further disease progression) includes the adequate treatment of recurrent episodes of rheumatic fever.

Mitral Valve Prolapse

  • Overview: Mitral valve prolapse is the most common heart valve condition, affecting 5 percent of the population in the United States. With mitral valve prolapse, the mitral valve bulges slightly back into the left atrium when it closes, allowing a small amount of blood to leak backward.
  • Signs and Symptoms: Symptoms such as minor chest pain or palpitations may occur.
  • Causes: Common causes of mitral valve prolapse include myxomatous degeneration, Barlow's syndrome, Marfan's syndrome, and rheumatic heart disease.
  • Risk Factors: There is a genetic component in a portion of patients with a familial incidence (family history) of mitral valve prolapse.
  • Diagnosis - Screening/Tests: An echocardiogram is a non-invasive test that uses high-frequency sound waves to create a moving picture of the heart chambers, the heart valves, and major blood vessels located near the heart.
  • Complications: Patients may develop endocarditis if antibiotics are not given prior to dental appointments. If the mitral prolapse is severe and symptoms are present, progressive heart failure can develop.
  • Treatment: Surgical valve repair is the treatment of choice in a surgical center that performs a high volume of mitral valve repair procedures.
  • Prevention: There is no treatment to prevent the development of mitral prolapse. Once mitral valve prolapse is present, it is best to treat the underlying cause of the mitral prolapse.

Contact

For more information regarding the Bluhm Cardiovascular Institute, please call 1-866-662-8467 or request a first time appointment online.

Last UpdateDecember 18, 2013
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