Mitral Valve Disease

The heart has valves to ensure that the blood flow is in the right direction. The mitral valve is situated between the right atrium and the main pumping chamber of the heart (the left ventricle) at the inflow of the left ventricle allowing it to fill with blood (known as diastole) when the valve is open before ejecting blood into the circulation (known as systole) when the valve is closed. The two main problems in mitral valve disease are narrowing (Mitral Stenosis, MS) and leaking Mitral Regurgitation (MR). Both have different effects on the heart however ultimately they can both cause serious problems with breathlessness and heart failure. If treatment to a heart valve is proposed it is preferable to do this before the heart becomes significantly damaged so early diagnosis and careful surveillance are important.

When investigating possible mitral valve disease in the clinic your cardiologist will need to take history and perform a physical examination. In addition they will want to perform some tests which will often include blood tests, a chest x-ray , ECG and echocardiogram. Further tests including a coronary angiogram , CT scan and MRI scan may also be necessary. Depending on the results your cardiologist may recommend continued follow up with medical therapy if appropriate and regular clinical surveillance including echocardiography.

If intervention is needed this will usually require surgical treatment (mitral valve repair, a mitral ring or replacement). Transcatheter mitral valve repair and replacement is complex and at a relatively early stage of development however it is a rapidly evolving field.

Image of normal mitral valve and leaking mitral valve-in this case due to prolapse

National Heart Lung and Blood Institute

Dr Dalby will discuss these tests, their implications and any subsequent tests, treatment or follow up with you so that you may reach a mutually agreeable management plan.