Mitral Valve Disease

Your heart is a powerful pump, constantly moving blood around your body. Heart valves are like one-way doors, making sure blood flows in the right direction.

What is mitral valve disease?

The mitral valve is a very important one because it controls the flow of blood from the lungs to the rest of the body. It's located between the left atrium (which receives blood from the lungs) and the left ventricle (which pumps blood to the rest of your body).

Mitral valve disease refers to a group of conditions that affect your mitral valve. Mitral valve disease means this important valve isn't working correctly, so blood doesn't flow smoothly from your lungs, through your heart, and on to the rest of your body. This can cause several health problems, affecting how you feel and potentially becoming serious if not treated.

Generally, mitral valve prolapse (MVP) is considered the most common type of mitral valve disease, affecting approximately 2 – 3% of the population. Mitral regurgitation (MR), which is often a consequence of MVP or other issues, is also quite prevalent, especially in older adults. Mitral stenosis (MS), while less common in developed countries due to the decline in rheumatic fever, still occurs today.

Mitral valve disease care at AHN: Why choose us?

At the AHN Cardiovascular Institute, you can experience advanced, patient-centered care from highly experienced and compassionate cardiologists. Our heart valve specialists offer many minimally invasive options to treat mitral valve disease. Our dedicated Mitral Valve Repair Reference Center* is focused on achieving reliable outcomes for our patients.

Our team creates a personalized treatment plan, because at AHN, we see you. We work closely with your other doctors, listen to your concerns, and deliver tailored care. Learn more about our team and our Mitral Valve Program.

Mitral valve disease symptoms and signs

Many people with mitral valve disease don't have any symptoms, especially at first. That's why regular checkups are so important. But as the disease gets worse, you might notice some of these:

• Shortness of breath: This is very common, often happening first during exercise, but it can happen even when resting. It's because your heart isn't pumping blood efficiently.
• Fatigue: Feeling tired and low on energy, even after getting enough sleep. Your heart might be working too hard.
• Heart palpitations: Feeling your heart racing or fluttering, like it's beating irregularly or too fast.
• Cough: A cough that doesn't go away, especially at night, might mean fluid is building up in your lungs.
• Swelling in your legs, ankles, and feet: This swelling is from fluid buildup because your heart isn't pumping blood well.
• Chest pain: This is less common with this condition, but it can happen if your heart is working extra hard.

These symptoms can be caused by other things besides mitral valve disease. If you are experiencing any of these symptoms, you should schedule an appointment with your doctor.

Causes and risk factors

 Mitral valve disease can be due to:

• Myxomatous degeneration (floppy valve disease): This is the most common cause. It is a common heart condition where the flaps of the mitral valve prolapse into the heart’s upper chamber. 
  
• A birth defect: Sometimes, the mitral valve isn't formed correctly from birth. Unless you have a family history of mitral valve disease or are experiencing symptoms, you would not know about this issue.
• Infections: Past infections like rheumatic fever (from strep throat) or endocarditis can cause scarring and narrow the valve.
• Heart attack: A heart attack can weaken the heart muscle supporting the valve.
• Connective tissue disorders: Conditions affecting your body's connective tissues (like lupus) can weaken the mitral valve.
• Age: The valve can just naturally wear out with age. Additionally, calcium deposits can accumulate on the mitral valve, thickening and narrowing it.
• Other heart conditions: High blood pressure or an enlarged heart can strain the valve.

Many people have mild mitral valve disease without even knowing it. But more serious cases need treatment to prevent complications. If you have any of these risk factors, discuss them with your doctor or a mitral valve specialist.

Risk factors for mitral valve disease include:

• Family history
  • Mitral valve prolapse and other heart valve problems can run in families.
• Medications and drugs
  • Some migraine medicines and older weight-loss medicines have been linked to heart valve disease.
  • MDMA (ecstasy) and other illegal drugs can increase the risk of mitral valve disease.
• Other risk factors
  • High blood pressure, high cholesterol, or diabetes
  • Smoking
  • Radiation therapy to the chest

Some of these risk factors can be managed or prevented while others cannot. Your AHN care team is here to help you navigate your risk.

Mitral valve disease screening and diagnosis

Finding mitral valve disease early is very important. Talk to your doctor about diagnostic testing if you have a family history of heart valve problems, a history of rheumatic fever, or other risk factors. These tests might include:

• Electrocardiogram (ECG or EKG): This painless test checks your heart's rhythm.
• Chest X-ray: This shows pictures of your heart and lungs.
• Echocardiogram: This uses sound waves to create detailed pictures of your heart and valve. It's the main test for mitral valve disease.
• Cardiac catheterization: A thin tube is used to measure pressure inside your heart.
  
• Cardiac MRI or CT scan: These are more detailed imaging tests.
• Physical exam: Your doctor will listen with a stethoscope to identify any potential murmurs that could indicate the disease.

Types of mitral valve disease

There are three main types of mitral valve disorders that cause blood to either flow backward, or restrict the amount of oxygenated blood flowing through your body:

• Mitral valve prolapse: The mitral valve flaps are floppy and bulge backward, letting some blood leak back. How much blood leaks back depends on how severe the prolapse is. When mitral valve prolapse worsens, it becomes mitral regurgitation — also called mitral valve insufficiency.
• Mitral valve regurgitation: Instead of all the blood being pumped forward into the aorta to circulate throughout the body, some of it leaks back into the left atrium. This backward flow is called regurgitation and could cause fatigue and shortness of breath.
• Mitral stenosis: This occurs when the mitral valve opening becomes narrowed, thickened, or stiff, impeding the flow of blood from the left atrium to the left ventricle. It can make it difficult for the left atrium to empty its blood into the left ventricle and it can create increased pressure within the atrium.

Doctors classify these by how severe they are (mild, moderate, severe) to help decide on the best treatment.

Mitral valve disease treatment

Living with mitral valve disease means regular checkups and following your doctor's advice. A healthy lifestyle helps, too. Early diagnosis and treatment give you the best chance for a good outcome.

• Percutaneous catheter-based treatments: These procedures are performed by inserting a catheter (a thin, flexible tube) into a blood vessel, usually in the groin, and guiding it to the heart. This avoids the need for a large incision in the chest and the use of a heart-lung bypass machine, which are typically required for open-heart surgery. Treatment depends on the type and severity of the disease, and your overall health. Potential treatment may include transcatheter edge-to-edge repair (TEER), and Transcatheter Mitral Valve Replacement (TMVR).
  
• Medicine: For mild cases, medicines might help. These could include medicines to reduce fluid buildup, help your heart work better, or prevent blood clots.
• Surgery: For moderate to severe cases, surgery is often needed. This could include:
  • Mitral valve repair: Fixing the valve without replacing it.
  • Mitral valve replacement: Replacing the valve with an artificial one.
  • Minimally invasive surgery: Newer techniques that use smaller cuts and cause less scarring.

Mitral valve disease FAQs

Any disease that affects the heart can be cause for concern and bring about questions. Your AHN care team is here to help you navigate this disease and provide answers to your specific questions, but we’ve also included these frequently asked questions that many patients have. These answers can help guide the conversations with your care team.

What is the life expectancy of person with mitral valve disease?

The life expectancy for individuals with mitral valve disease varies significantly depending on the specific type of disease, its severity, whether it's treated, and the presence of other health conditions.

• Mitral regurgitation (leaky valve): If mild or moderate, life expectancy can be normal, especially if closely monitored. Severe, untreated mitral regurgitation can lead to heart failure and reduced life expectancy. However, with timely surgical repair or replacement, outcomes are generally very good, often leading to a life expectancy close to that of the general population.
• Mitral stenosis (narrowed valve): This condition tends to progress, and severe, untreated mitral stenosis can significantly reduce life expectancy due to complications like heart failure or pulmonary hypertension. With successful treatment (like balloon valvuloplasty or valve replacement), life expectancy can be significantly improved.
• Mitral valve prolapse (MVP): For the vast majority of people with MVP, especially those without significant regurgitation, life expectancy is normal. Only a small percentage of MVP cases progress to severe forms that might impact life expectancy, and these are often managed effectively.

Regular monitoring and appropriate medical or surgical intervention are key factors in maintaining a good quality of life and improving long-term outcomes for most forms of mitral valve disease.

Is mitral valve disease serious?

Yes, mitral valve disease can be serious, but its seriousness ranges from very mild to life-threatening. It depends on the specific condition, its severity, and how it affects heart function.

• Mild mitral valve disease: Many people have mild forms of mitral valve disease (like mild mitral valve prolapse or mild regurgitation) that cause no symptoms and may never progress to a severe stage. In these cases, it may not be serious and simply requires monitoring.
• Moderate to severe mitral valve disease: This is where the condition becomes more serious.
• Mitral regurgitation: If severe, the heart has to work harder, which can lead to enlargement of the heart chambers (atria and ventricles), heart failure, and irregular heart rhythms (like atrial fibrillation).
• Mitral stenosis: Can lead to pressure buildup in the lungs (pulmonary hypertension), shortness of breath, and heart failure.
• Complications: Serious complications can include heart failure, stroke (due to blood clots forming in enlarged atria), pulmonary hypertension, and endocarditis (infection of the heart valve).

The good news is that with modern diagnostic tools and treatment options (medications, valve repair, or valve replacement), many serious forms of mitral valve disease can be effectively managed, preventing or alleviating severe complications.

How long can a person live with mitral valve prolapse?

For the vast majority of individuals with mitral valve prolapse (MVP), life expectancy is normal and is comparable to that of the general population.

MVP is often a benign condition, meaning it doesn't cause significant problems for most people. Many don't even know they have it. It's only a small percentage of individuals with MVP who develop complications, primarily significant mitral regurgitation (a leaky valve). Factors that might influence life expectancy in a small subset of MVP patients include:

• Severity of mitral regurgitation: If the prolapse leads to severe leakage, it can strain the heart over time and lead to heart failure. However, this is often treatable with surgery.
• Development of complications: Such as atrial fibrillation (an irregular heartbeat) or endocarditis.
• Other underlying heart conditions

Regular follow-up with a cardiologist is recommended for individuals with MVP, especially if there's any associated regurgitation, to monitor the condition and intervene if it progresses.

What foods should you avoid with mitral valve prolapse?

For most people with uncomplicated mitral valve prolapse (MVP), there are no specific foods that you absolutely must avoid. The recommendations are generally the same as those for a heart-healthy diet for the general population.

However, some individuals with MVP, particularly those who experience symptoms like palpitations, anxiety, or lightheadedness, might be sensitive to certain substances. If you notice these symptoms are triggered or worsened by specific foods or drinks, it's worth discussing this with your doctor. Potential triggers could include:

• Excessive caffeine: Found in coffee, tea, energy drinks, and some sodas. Caffeine can sometimes exacerbate palpitations or anxiety in sensitive individuals.
• Excessive alcohol: Can also contribute to palpitations and an irregular heartbeat.
• High sodium (salt) Intake: While not directly related to the valve itself, reducing sodium is part of a general heart-healthy diet and can help manage blood pressure, which is beneficial for overall cardiovascular health.
• Highly processed foods: These often contain high levels of unhealthy fats, sodium, and sugars, which are detrimental to heart health in general.

Instead of focusing on what to avoid (unless you have specific sensitivities or other coexisting conditions like high blood pressure), the emphasis should be on a balanced, heart-healthy diet:

• Rich in fruits, vegetables, and whole grains
• Lean proteins
• Healthy fats (like those found in olive oil, avocados, and nuts)
• Low in saturated and trans fats
• Limited added sugars

Always discuss any dietary concerns or proposed changes with your AHN care team, as they can provide personalized advice based on your specific condition and overall health.

Contact us

If you have risk factors for mitral valve disease, are experiencing symptoms, or have already been diagnosed with mitral valve disease, we’re here to help get you the personalized care you need.

Not yet diagnosed

If you don’t have a diagnosis, call (412) DOCTORS 412-362-8677 to make an appointment with your primary care provider. They will explore all possible causes of your symptoms.

If you don’t have a PCP, Find Care can help you find a primary care physician. You can read patient reviews, select your provider, view service locations and appointment times then, schedule your appointment online.

New patient appointments and second opinion requests

Call the AHN Mitral Valve Program for more information or to schedule an appointment at 855-4MITRAL 855-464-8725.

Scheduling diagnostic tests or treatment

If you have a referral and are ready to schedule your procedure, please call the facility where you would like to have the procedure done: