What Makes The Mitral Valve Such An Important Component Of A Healthy Heart
A properly functioning mitral valve, situated between the left atrium and left ventricle, opens as the left atrium fills with blood. As the heart expands, blood flows into the hearts main pumping chamber, the left ventricle. The mitral valve then closes as the heart contracts, pushing oxygenated blood into the bodys largest artery, the aorta.
When the mitral valve doesnt work as it should, however, your heart might not pump enough of the oxygen-rich blood to your body. Mitral valve regurgitation, the most common heart-valve disorder, is a leaky valve that allows blood to flow backward into the left atrium. A diseased valve can cause shortness of breath, dizziness, fatigue, chest discomfort, migraines and many other symptoms.
At Hartford HealthCares Heart & Vascular Institute, our goal is to repair — whenever possible — your own living valve. Our results, and multiple studies, confirm that repair is better than replacement, with a reduced risk of complications, no blood thinners , better quality of life and greatly enhanced chances of a longer life.
But not every patient is a candidate for mitral valve repair. Patients too ill for either repair or replacement now have a nonsurgical option: the MitraClip, a mesh clip delivered through a catheter that reinforces the mitral valve and prevents blood backflow.
How Are Leaky Valves Diagnosed And Treated
Doctors diagnose leaky valves primarily through listening for heart murmurs with a stethoscope. Whether you come in for a routine physical or after noticing symptoms, this is often the first way leaks are detected. When there are symptoms or a doctor hears a murmur, the next step is an echocardiogram, an ultrasound of the heart, to determine the final diagnosis.
The good news about leaky heart valves is that they are highly treatable. Treatment varies based on the cause and how much the leak is affecting the body. Many minor valve leaks are simply observed for change over time. Regular follow up and routine health visits are important as a part of the observation process. Depending on which valve is leaking, medicines ranging from diuretics to reduce swelling to blood pressure medications called vasodilators may be used to correct the leaking valve. Some are treated by treating the underlying cause such as blood pressure, high cholesterol, or diabetes. Your symptoms and the results of your echocardiogram are used to determine how serious the leak is. In the most serious cases, valve repair or replacement surgery is the necessary treatment.
What Do Heart Valves Do
Your blood flows around your heart and the rest of your body in one direction, like a one-way traffic system. Your heart valves control the direction of your blood flow. They have very small flaps of skin called leaflets that open and close like doors with every heartbeat. They stop the blood flowing backwards.
There are four valves in your heart, they are:
- the tricuspid valve and the pulmonary valve on the right side of the heart
- the mitral valve and the aortic valve on the left side of your heart.
The human heart works like a pump sending blood around your body to keep you alive. The blood delivers oxygen and nutrients to all parts of your body to help your organs and muscles work properly.
Find out more about how your heart works.
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What Is The Outlook For A Bicuspid Aortic Valve
Survival rates for aortic valve surgeries are relatively high. People who have valves repaired may need subsequent repairs made if they are young. Valve replacement procedures are usually permanent.
A 2021 study comparing survival rates among various bicuspid aortic valve patient groups suggests that low risk individuals between the ages of 60 and 64 experienced a median survival time after surgery of about 16 years.
Those age 85 and older had about a 6-year survival expectancy. Individuals in high risk groups averaged somewhat lower life expectancy outcomes.
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Treatment For Leaky Heart Valves
You doctor may prescribe medications to maintain adequate pumping action of the heart.Since major valvular leakage is a mechanical problem, it is eventually required to be replaced by surgery. Valvular surgeries may be of the following types:
Valve repair surgery a damaged valve is fixed without use of prosthetic. Valve replacement surgery this is performed when valve repair is not possible. The damaged valve is replaced by a prosthetic or artificial one. Minimally invasive heart valve surgery
Patients are required to be on blood-thinning agents even after surgery. This helps to prevent formation of blood clots on the repaired/ replaced heart valve post-surgery.The patients need to be serially tested for PT/INR once put on medications to assess and adjust dosages if required.Whether you are diagnosed with a valve condition or not, there are certain measures which you can take to manage and also avoid development of valvular/ cardiac conditions in future:
- Curb smoking and alcohol intake
- Maintain an optimal weight and BMI
- Eat a well balanced diet
- Those at high risk should consume a salt-restricted and fat-free diet.
- Follow a suitable exercise program. High-intensity exercises are to be avoided for patients with leaky valve
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Dr Marques first treated me when I was having a cardiac arrest. He explained to my family what was happening, what had to happen and what the results could be. He treated me by placing a tent to open up an artery. After four days in the hospital, I started office visits, twice a year, and this all happened well over ten years ago. I follow his medical advise and I havent felt better than I do now. He knows his stuff.
How Is A Leaky Heart Valve Treated
Some cases dont require any treatment. But treatment may be necessary if the condition:
- Affects your ability to have an enjoyable or productive life.
- Causes troubling symptoms.
- Places a strain on your heart.
- Threatens to shorten your life span.
If needed, there are many types of heart valve surgery to repair or replace a leaky valve. Your healthcare team will help you decide what procedure is right for you. The decision will be based on which valve is involved and the particular cause of the leak.
Some examples of procedures include:
- Valve repair, which often includes an annuloplasty which is a ring that is used to tighten or reinforce the leaky valve.
- Procedures to place a clip on the valve.
- Surgery to replace the leaking valve with a device made of carbon and metal.
- Surgery to replace the valve with one donated from a deceased human or animal.
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Causes Of A Leaky Aortic Valve
A leaky heart valve that is localized to the aortic valve causing aortic regurgitation can be caused by a few different things. WebMD explains that it can be the result of a bicuspid aortic valve, which means the valve has two flaps instead of the normal three. It can also be due to high blood pressure , an infection in the heart valve , , or rheumatic heart disease.
What Else Should I Ask My Healthcare Provider
To learn more about how a leaky heart valve is affecting you, consider asking your healthcare provider:
- Which valve is affected?
- What is causing the leaky valve?
- What lifestyle changes might help?
- Should I have a procedure to repair or replace the heart valve?
- Can I still do all of my normal activities?
- What is my prognosis?
A note from Cleveland Clinic
A leaky heart valve doesn’t close properly when the heart beats. Heart valve leakage can place extra strain on the heart and cause symptoms or even heart failure. If you have symptoms of a leaking heart valve, talk to your healthcare provider. There are many ways to repair or replace a valve, and lifestyle changes may help.
Last reviewed by a Cleveland Clinic medical professional on 03/09/2021.
References
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A Holistic Approach To Heart Valve Care
Dr. Shivaraju and her colleagues can diagnose structural problems with the heart, including mitral valve disease, with the help of an echocardiogram . Diagnosis is accompanied by a holistic plan that factors in your physical, emotional, social and spiritual needs.
“In patients with mitral regurgitation as a result of a failure of their heart pump, we first optimize their heart failure medication regimen, and educate them on the importance of proper diet and medication compliance no medicine can help you if you don’t take it as prescribed,” said Dr. Shivaraju. “If, despite these measures, they are still having symptoms, we use MitraClip to minimize the leak and improve their symptoms.”
For patients who are considered high-risk for open-heart surgery, or for whom surgery is not likely to be effective in fixing the mitral valve problem, AMITA Health offers MitraClip as a treatment option. And it is just one of many innovative treatments employed by Dr. Shivaraju and her colleagues.
“As we continue to expand the comprehensive cardiovascular program at AMITA Resurrection, it’s really important to have every type of treatment available, including the latest minimally invasive procedures such as transcatheter aortic valve replacement and WATCHMAN implant for patients with AFib,” says Dr. Shivaraju.
Living With A Leaky Heart Valve
Everyone with a leaky heart valve can benefit from daily exercise, like walking. Before engaging in competitive or contact sports, people with severe valve regurgitation should talk with their doctors.
Not smoking and maintaining a healthy weight are just as important for people with leaky heart valves as for other people. Regular follow-up with a doctor, even when there are no symptoms, can ensure a leaky heart valve does not cause problems that could be avoided.
Show Sources
Borgeson, D. Journal of the American Society of Echocardiography, 1996 vol 9: pp 832-837. Enriquez-Sarano, M. New England Journal of Medicine, 2004 vol 351: pp 1539-1546.
Otto, C. New England Journal of Medicine, 2001 vol 345: pp 740-746.
Bonow, R. Circulation, 2008 vol 118: pp e523-661.
Guenther, T. European Journal of Cardio-thoracic Surgery, 2008 vol 34: pp 402-409.
Lee, J. Circulation Journal, 2010 vol 74: pp 375-380.
Libby, P. Braunwaldâs Heart Disease: A Textbook of Cardiovascular Medicine, 8th edition, Saunders Elsevier, 2007.
Childrenâs Hospital of Wisconsin: âAnatomy and Function of the Heart Valves.â
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Warning Signs Of Heart Valve Disease
If you are you experiencing any of these symptoms, talk to your primary care doctor or cardiologist:
These red flags can occur at any age.
“Valve problems, especially in the aortic and mitral valve, are not always limited to older patients. Young people with rheumatic heart disease can develop valve disease, and some people have congenital birth defects in their valves, including the mitral valve,” says Dr. Shivaraju.
What Is The Treatment For A Bicuspid Aortic Valve
Depending on the severity of your bicuspid aortic valve, treatment options range from regular appointments with your cardiologist to valve repair or replacement surgery.
If there are no symptoms, doctors may monitor your heart periodically with echocardiograms. Theyll look for changes in valve function or signs that the heart is having to work harder.
You should discuss with your doctor whether you need antibiotics before any dental procedures. Some doctors recommend antibiotics for people at risk of developing endocarditis from an infection.
Although the American Heart Associations guidelines no longer include a bicuspid aortic valve as a major risk factor, there are some cases where your doctor may still recommend antibiotics.
When symptoms are present, you may need to replace or repair the valve. In some cases, doctors perform these procedures as open heart surgery. For others, the procedure can be done with a catheter inserted into a blood vessel in the leg and guided up to the heart.
If aortic stenosis has developed, the valve may have to be replaced. The replacement will be a tricuspid valve, either mechanical or made from valve tissue harvested from a cow or pig.
Doctors may advise people who get a mechanical valve to take blood thinners for life to prevent blood clots from forming in the heart.
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What Is Mitral Valve Prolapse What Causes It And What Does It Look Like
Mitral valve prolapse is the most common heart valve abnormality. The condition is slightly more prevalent in women than in men. The mitral valve is one of the four heart valves. A normal mitral valve consists of two thin leaflets, located between the left atrium and the left ventricle of the heart. Mitral valve leaflets, shaped like parachutes, are attached to the inner wall of the left ventricle by a series of strings called chordae. When the ventricles contract, the mitral valve leaflets close snugly and prevent the backflow of blood from the left ventricle into the left atrium. When the ventricles relax, the valves open to allow oxygenated blood from the lungs to fill the left ventricle.
In mitral valve prolapse, the mitral apparatus becomes affected by a process called myxomatous degeneration. In myxomatous degeneration, the structural protein collagen forms abnormally and causes thickening, enlargement, and redundancy of the leaflets and chordae. Blood normally flows through the mitral valve from the left upper chamber to the left lower chamber of the heart. When the ventricles contract, the redundant leaflets prolapse into the left atrium, sometimes allowing leakage of blood through the valve opening back into the left atrium. When severe, mitral regurgitation can lead to heart failure and abnormal heart rhythms. Most people are unaware of the prolapsing of the mitral valve. However, others may experience a number of symptoms.
What Are The Symptoms Of Different Types Of Heart Disease
Chest pain from the heart muscle because it doesnt have adequate oxygen and nutrient-rich arterial blood flow, also called angina, is a common symptom of heart disease. Angina causes you to feel discomfort in your chest. Some people experience tightness or a squeezing sensation around their breastbone. The pain may radiate to the neck, down the shoulder and arms or upper abdomen, or into the upper back.
If youre very tired or have difficulty catching your breath after minor exertion, you may have symptoms of heart disease. These symptoms typically ease with rest.
Women often experience different symptoms than men. For example, women may have:
- lightheadedness
- fainting episodes
Women may not recognize the symptoms of heart disease. This is because their symptoms may also occur with other illnesses. Women also tend to have other risk factors, such as depression, stress, and menopause.
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How Is Heart Valve Disease Treated
A heart valve problem can be serious if its not treated. Although you cant undo damage to a heart valve, you can treat the issue.
Heart valve disease treatments depend on the underlying cause and may include:
- Protecting your valve from further damage.
- Taking medications.
- Having surgery or invasive procedures if necessary.
- Seeing your heart doctor for regular visits.
The decision to prescribe medical treatment, surgical repair or surgical replacement depends on several factors, including:
- The type of valve disease.
- The severity of the damage.
- Your medical history.
If youre pregnant and have heart valve disease, you can get extra rest and/or take certain medicines that are safe for your baby.
If you know about your valve disease before pregnancy, you should ask your healthcare provider if any tests or visits with a cardiologist are recommended before trying to become pregnant. This can help ensure that you are treated appropriately before and during pregnancy. If you have a severe valve problem, your doctor may recommend valve repair or replacement before pregnancy.
Surgical repair or replacement
Heart valve disease is a mechanical problem in the opening or closing of the leaflets, and you may eventually need surgery to repair or replace your valve. Some infants and children who are born with a valve problem need surgery during childhood.
Often, valve surgery may be combined with other procedures to fully treat your heart disease.
Low Heart Rate Variability
A study conducted in 2011 looked into sleep patterns in people with ME/CFS in order to better understand the common symptom of unrefreshing sleep. They found, that people with ME/CFS had little variation in their heart rate from day to night, a condition known as low heart rate variability .
To understand this, feel your pulse and then breathe in and out slowly. Youll notice that your heart rate changes slightly, faster when you breathe in and slower when you breathe out. Thats heart rate variability.
A low night-time HRV suggests that there may be a problem with the regulation of the hearts natural pacemaker . This is in line with the theory that ME/CFS could be caused, at least in part, by flaws in the autonomic nervous system, which regulates automatic functions such as breathing, digestion, and heart rate.
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Symptoms Of A Leaky Heart Valve
Frequently, a leaky heart valve causes no symptoms. Many healthy people have one or more valves that are slightly leaky.
If the heart valve leak is severe, it may impair the forward flow of blood. This can cause symptoms of congestive heart failure, which include:
- Shortness of breath, especially with exertion or when lying flat
- Leg swelling or fluid retention elsewhere in the body
Other symptoms of a leaky heart valve may include:
- Lightheadedness
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What Happens In Mitral Valve Prolapse
The mitral valve is between the left atrium and the left ventricle. It helps make sure that blood flows in one direction only as it passes from the left atrium into the left ventricle:
Each time the heart beats, the left ventricle pumps blood out to the body.
The mitral valve has two flaps of tissue that swing shut to prevent the blood in the ventricle from flowing backward into the left atrium.
In mitral valve prolapse, one or both flaps bulges back into the atrium when they shut, a bit like a balloon. This may happen because the flap has an unusual shape or is a little too big.
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