Description The mitral valve se...
Description
The mitral valve separates the upper and lower chambers on the left side of the heart (left atrium and left ventricle). When the valve opens, blood flows from the left atrium to the left ventricle. When it closes, it prevents blood from flowing backward. In mitral regurgitation the blood flows backward into the atrium when the ventricle contracts. This backward flow causes enlargement of the left atrium and increased pressure in the lungs. The enlargement of the left atrium can cause an abnormal rhythm of the heart called atrial fibrillation. The increased pressure in the lungs can cause shortness of breath. The most common causes of mitral regurgitation include: mitral valve prolapse, infection of the valve (endocarditis), damage to the valve from a heart attack, rheumatic fever, wear and tear of the valve, untreated high blood pressure, and congenital heart disease.
Symptoms
Symptoms may develop gradually and include: chest pain, cough, fatigue, exhaustion, palpitations, shortness of breath during activity, shortness of breath when lying down (orthopnea), excessive urination at night (nocturia).
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be done. The provider may hear an abnormal heart sound called a murmur. Other tests may be done to detect the damage to the heart and lungs. Test that can diagnose the backward blood flow and abnormal mitral valve include: echocardiogram, transesophageal echocardiogram, and catheterization of the heart.
Tests:
Cardiac catheterization, Echocardiogram (ECHO), Electrocardiogram (EKG), Transesophageal echocardiogram (TEE)
Do I need this test?
Don't perform echocardiography as routine follow-up for mild, asymptomatic native valve disease in adult patients with no change in signs or symptoms. Patients with native valve disease usually have years without symptoms before the onset of deterioration. An echocardiogram is not recommended yearly unless there is a change in clinical status.
Specialists:
Cardiothoracic Surgery, Cardiology, Pediatric Cardiology
Workup:
A history and physical exam will be done. The provider may hear an abnormal heart sound called a murmur. Other tests may be done to detect the damage to the heart and lungs. Test that can diagnose the backward blood flow and abnormal mitral valve include: echocardiogram, transesophageal echocardiogram, and catheterization of the heart.
Tests:
Cardiac catheterization, Echocardiogram (ECHO), Electrocardiogram (EKG), Transesophageal echocardiogram (TEE)
Do I need this test?
Don't perform echocardiography as routine follow-up for mild, asymptomatic native valve disease in adult patients with no change in signs or symptoms. Patients with native valve disease usually have years without symptoms before the onset of deterioration. An echocardiogram is not recommended yearly unless there is a change in clinical status.
Specialists:
Cardiothoracic Surgery, Cardiology, Pediatric Cardiology
Treatment
Therapy depends on the symptoms being experienced and damage being done to the heart and lungs. Those with mild symptoms may be observed. Treatment includes: medications to help improve the heart function, surgical repair of the valve, and surgical replacement of the valve. Artificial heart valves are made from tissue or metal. Metal valves last longer but require lifelong blood thinners such as warfarin/Coumadin. Tissue valves are made from pig, bovine or human cadaver tissue and do not require blood thinner medications but do not last as long and many times have to be replaced. Medications that may be used include diuretics, vasodilators and antiarrhythmics if there is an abnormal heart rhythm such as atrial fibrillation. Antibiotics may be prescribed to prevent infection of the valve before dental work, gastrointestinal procedures, and urinary tract procedures.