What is Mitral Valve? And What Are The Diseases?

Mitral Valve

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What is Mitral Valve? And What Are The Diseases?

The mitral valve is a valve located between the left atrium and left ventricle of the heart and allows one-way blood flow. This cap has two leaves and its leaves are attached to the ventricle muscle with threads like parachute threads.

The mitral valve is basically formed by the union of 4 structures:

  • Cover leaflets
  • Cover ring (annulus)
  • Papillary muscles (muscles that provide the movement of the lid)
  • Chordea tendinae (the filaments that connect the muscles to the leaflets)

What Does The Mitral Valve Do? How Does İt Work?

When the heart relaxes, the mitral valve opens and clean blood from the lungs in the left atrium passes through the mitral valve and fills the left ventricle. When the left ventricle contracts to pump this blood through the aorta to the body, the mitral valve closes, preventing this blood from returning to the left atrium, and all the blood is pumped throughout the body.

What are Mitral Valve Diseases?

  1. What is Mitral Stenosis?

The mitral valve is located between the left atrium and the left ventricle, consists of 2 leaflets (bicuspid). The blood filled with oxygen in the lungs comes to the left atrium via the pulmonary veins, and from there it empties into the left ventricle by passing through the mitral valve. Then the left ventricle contracts and throws the blood into the aorta to distribute it throughout the body. At this time, the mitral valve closes to prevent blood from returning to the left atrium and the aortic valve opens. Normally, the mitral valve area is 4-6 cm2. If valve stenosis occurs (in some cases described below), the valve area narrows, making it difficult for blood to drain from the left atrium into the left ventricle.

What are The Causes of Mitral Stenosis Disease?

Mitral stenosis (MS) is a condition primarily linked to rheumatic heart disease, which stands as its most common cause. This disorder alters the structure of the valve leaflets, leading to deformities, stiffening, calcification, and the formation of adhesions at the tips of the valves. These changes prevent the valve from opening fully, restricting blood flow. In rare cases, mitral stenosis can also occur as a congenital defect, present from birth.

What are The Symptoms of Mitral Stenosis Disease?

  • Shortness of breath,
  • Heart Palpitations,
  • Rhythm Disorder,
  • Chest Pain,
  • Fainting,
  • Swelling in the legs,
  • Vomiting blood and being unable to lie down

May be signs of heart valve disease.

Many of these symptoms usually occur at the same time. Identifying the symptoms of heart valve disease is important in the surgical decision-making process.

What is The Treatment of Mitral Stenosis Disease?

When the surface area of the eyelid remains above 2.5 cm², there‘s usually no cause for concern. At this stage, preventive antibiotics are generally sufficient. To alleviate or manage shortness of breath caused by a narrowing in the valve area, doctors often recommend sodium restriction and diuretics. However, when the surface area drops below 1.5 cm², medical intervention with specialized treatment becomes necessary.

Two methods are used for this purpose:

  • Mitral Balloon Valvuloplasty (MBV):

First assess the patient’s suitability for this approach. This can be done if the physical properties of the valve are suitable and there is no clot in the left atrium.

In this method, a special balloon is used to expand the valve by reaching the inguinal vein without surgery. For this, it is sufficient for the patient to stay in the hospital for a few days.

  • Surgical:

Surgery is required if the valve is not suitable for MBV. In this method, if the lid is not very deformed, its adhesions are opened and expanded. However, if its structure is very deteriorated, it is replaced and an artificial valve (prosthesis) is placed.

  1. What is Mitral Valve Insufficiency?

Mitral valve regurgitation is a heart valve disease in which the mitral valve between the chambers on the left side of the heart does not close completely and blood flows backwards through the valve.

In this case, the blood cannot move in the direction it should and leakage occurs. The severity of the leak gives information about the course and severity of the disease. If the severity of the leakage is high, enough blood cannot go to the heart and body. This causes the person to feel tired and short of breath.

Mitral valve regurgitation occurs due to an issue with the heart’s structure that disrupts the proper flow of blood. For oxygen-rich blood to be pumped efficiently from the heart to the rest of the body, it must travel from the left atrium to the left ventricle. The mitral valve, a structure that facilitates this passage between the two chambers, plays a crucial role. The malfunction associated with this condition stems from defects or problems within the mitral valve itself.

What are The Causes of Mitral Valve Insufficiency?

  • Rheumatic Heart Disease:

It is rare for rheumatic heart disease to cause MR alone. More often, mitral stenosis is also found together in various degrees.

  • Mitral Valve Prolapse:

It is one of the common causes especially in developed countries.

  • Conditions that Expand the Left Ventricle:

Mitral valve margins are between left ventricle and left atrium. The enlargement of the left ventricle also enlarges the periphery of the valve.

Thus, although there is no problem in the lid tissue, since the circle to which the lid is attached expands, the lids cannot come together when they are closed and MR occurs. Any cause of left heart failure can therefore also cause MR: hypertension, heart attack, cardiovascular disease, aortic insufficiency, aortic stenosis, cardiomyopathy, etc.

  • Congenital (Congenital):

Congenitally, there may be a structural defect or deficiency in the mitral valve or the structures to which it is attached.

  • Cap Tear Or Breakage Of The Threads (Cord) Holding The Cover:

Blunt blows to the chest, heart attack, endocarditis.

  • Calcification of the Mitral Valve Attachment (Mitral Annulus Calcification):

It is common in the elderly and its incidence increases with age. However, serious MR is rare.

What are The Symptoms of Mitral Valve Insufficiency?

Mitral valve regurgitation can sometimes continue for years without showing any symptoms. They usually progress slowly. Rarely, acute mitral valve regurgitation may occur. It can occur suddenly and cause sudden symptoms. A common symptom of this valve regurgitation is patient fatigue.

Additional symptoms include the following:

  • Heart palpitations. A palpitation, especially when you lie on the left side, may be a sign of mitral valve insufficiency.
  • Arrhythmia (Irregular heartbeat)
  • Heart murmur
  • Shortness of breath that may increase in the lying position
  • Rapid breathing
  • Cough
  • Edema manifested by swelling, especially in the wrists and ankles
  • Chest pain

How is Heart Valve Failure Diagnosed?

The main reason for the occurrence of mitral valve regurgitation is damage to the mitral valve. This situation may have occurred for the following reasons.

  • Congenital Heart Defects:

Congenital heart diseases can be related to the general structure of the heart or sometimes to the heart valves.

  • Heart Attack:

The severity of a heart attack can damage the muscles of the heart. If the injured muscles are around the mitral valve, mitral valve insufficiency may be seen.

  • Mitral Valve Prolapse:

This condition is also known as mitral valve prolapse or collapse.

This is a difficulty in the valve’s function and can lead to mitral valve insufficiency.

  • Rheumatic Fever:

It occurs as a result of a throat infection caused by a type of bacteria. It is also known as cardiac rheumatism. Rheumatic fever can also damage heart valves. This can occur early in life or later in life.

  • Cardiomyopathy:

It is a problem of thickening of the heart muscle. The heart has trouble pumping blood and the valves can be damaged.

  • Cardiac membrane (endocarditis) infections
  • Damaged tissues in the heart
  • Radiotherapy applications applied to the chest area

Treatment

The severity of mitral valve insufficiency plays a crucial role in determining the appropriate treatment approach.For mild to moderate insufficiency, medication is commonly prescribed to alleviate the strain on the left ventricle.

This typically includes diuretic medications as well as dietary salt restrictions. In severe mitral valve insufficiency, surgical intervention may be necessary in addition to pharmacological treatment, depending on the patient’s symptoms and overall condition.

Surgical options include repairing or replacing the affected heart valve. For patients deemed high-risk for conventional surgery, alternative procedures are employed to help manage the symptoms of heart failure.

In these situations, blood-thinning medications are administered to reduce the risk of blood clots.Advances in medical technology have made minimally invasive surgical techniques increasingly common.

These procedures allow access to the heart and valve repair or replacement through smaller incisions, such as in the lower chest, side of the chest, or armpit.

In summary;

Thanks to ongoing technological innovations, less invasive heart surgeries are now possible, resulting in shorter recovery times for patients and highly successful outcomes.

Pay Attention to These About Mitral Valve Insufficiency!

Some lifestyle changes have a key role in relieving the symptoms of problems such as heart disease and mitral regurgitation and preventing their progression.

The changes can be outlined as follows:

A Healthy Diet:
  • In order to prevent heart diseases, you should choose a healthy and balanced diet model that will be good for the cardiovascular system.
  • Remember that the most accurate nutrition plan and weight control for you can only be provided by a dietitian who is an expert in the field.
  • Avoid fast foods, refined sugars, trans fats and packaged foods. Instead, include healthy oils such as olive oil or fish oil, whole grain products, vegetables and fruits, and raw nuts.

Exercise:

  • Incorporate walking and a sport that suits you in consultation with a health professional.
  • Stay away from alcohol, smoking and harmful habits. Choose a stress-free life.
  • Don’t forget to have regular health check-ups.
If you have a heart condition or suspect mitral valve insufficiency, make it a priority to schedule an appointment with the cardiovascular diseases department and consult a specialist cardiologist.

Mitral Valve: Frequently Asked Questions

What is the mitral valve and what is its main function?

The mitral valve (also known as the bicuspid valve) is a dual-flap valve located between the left atrium and the left ventricle of the heart. Its primary function is to regulate blood flow, ensuring that oxygen-rich blood moves forward from the lungs into the left ventricle and preventing it from flowing backward (regurgitation) during a heartbeat.

Because the left side of the heart pumps blood to the entire body, the mitral valve is under high pressure. This makes it one of the most common valves to develop structural or functional issues over time.

What is Mitral Valve Prolapse (MVP)?

Mitral Valve Prolapse (MVP) is a condition where the valve’s flaps (leaflets) are “floppy” or enlarged. Instead of closing tightly, they bulge or collapse backward into the left atrium when the heart contracts.

While many people with MVP have no symptoms and require no treatment, it can sometimes lead to mitral regurgitation. Doctors often identify MVP by hearing a specific “click” or murmur through a stethoscope during a routine exam.

What are the differences between Mitral Regurgitation and Mitral Stenosis?

These are the two primary types of mitral valve disease:

  • Mitral Regurgitation (Leaky Valve): The valve does not close completely, allowing blood to leak backward. This forces the heart to work harder to circulate blood, which can lead to heart failure if left untreated.
  • Mitral Stenosis (Narrow Valve): The valve opening becomes stiff or narrowed, making it difficult for blood to pass from the atrium to the ventricle. This is often caused by calcium buildup or history of rheumatic fever.
What are the common symptoms of mitral valve disease?

Symptoms of mitral valve issues often develop slowly. Many patients remain asymptomatic for years until the condition progresses.

Common signs include:

  • Dyspnea: Shortness of breath, especially during exertion or when lying flat.
  • Fatigue: Feeling unusually tired, even after rest.
  • Palpitations: Sensations of a rapid, fluttering, or irregular heartbeat (often linked to Atrial Fibrillation).
  • Lightheadedness: Dizziness or fainting spells.
  • Swelling (Edema): Swelling in the ankles or feet due to fluid buildup.
How do doctors diagnose mitral valve problems?

The diagnosis usually begins with a physical examination where a doctor listens for a heart murmur. To confirm the diagnosis and assess the severity, the following tests are used:

  • Echocardiogram: The most important tool. It uses ultrasound waves to create images of the valve in motion.
  • Transesophageal Echo (TEE): A more detailed ultrasound performed through the esophagus to get a closer look at the valve.
  • Cardiac MRI: Provides highly detailed images of heart structure.
  • Stress Test: Evaluates how the valve performs during physical activity.
Is mitral valve repair better than replacement?

Whenever possible, surgeons prefer mitral valve repair over replacement. Repairing the natural valve preserves the heart’s own tissue and structure, often resulting in better long-term heart function and avoiding the need for long-term blood thinners.

However, if the valve is too damaged, a replacement is necessary. Patients can receive a mechanical valve (highly durable but requires life-long blood thinners) or a bioprosthetic (tissue) valve (often from a cow or pig, which does not require long-term anticoagulants but may wear out sooner).

 

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