About the disease
Mitral valve insufficiency is a heart defect, when the mitral valve is unable to pump out the blood from the heart. This is the most common form of all valvular disorders. Every sixtieth patient with heart disease has mitral valve insufficiency. Usually people with insufficient mitral valve also develop the mitral stenosis, when the right atrioventricular orifice becomes narrowed.
There are two types of mitral valve insufficiency: congenital and acquired. Congenital one may be caused by adverse factors experinced by mother during pregnancy. Such adverse factors include smoking, alcohol consumption, infections and polluted environment. Acquired insufficiency of the valve can be result of trauma or tumor. It can also be provoked by rheumatism or infectious illness called endocarditis, which is a malformation of the inner lining of the heart.
Usually insufficiency is caused and accompanied by mitral valve prolapse. It means there is a bulging of one or both heart valves, that separate atrium of the left side from the ventricle. Prolapse is usually detected in young people between 15-30 years old. There are primary and secondary mitral valve prolapse syndromes. Causes of primary prolapse are hereditary or congenital diseases of connective tissue of the heart. The predisposition for secondary mitral valve prolapse is the same as for insufficiency: rheumatism or inflammation process of the heart. Sometimes it may be provoked chest injuries. Most people have no symptoms of mitral valve prolapse. In rare cases a person may complain of pain in the heart, which is usually occurring when a person is emotionally moved or when he conducted some kind of physical activity.
- Dry cough
- Difficulty breathing
- Stagnation of blood vessels in the lungs
- Heart palpitations
- Irregular heartbeat
- Upheavals in the left side of the chest
Patients with insufficient mitral valve can also feel dizziness in the morning or before the sleep and their heartbeat may become unstable due to the disruptions in the heart rhythm.
- First of all a doctor conducts an analysis of medical history and patient`s complaints. Then he needs to know if the patient has relatives who suffered from heart diseases to see if patient has genetic predisposition. Physical examination includes auscultation (thorough listening to the heart) through a special device. If a doctor detects a mitral valve insufficiency murmur, he requires patient to have analysis of blood to see if there is any inflammation process or associated diseases. The blood test also determines the level of cholesterol, blood sugar and creatinine.
- The most important diagnosis of insufficient mitral valve is electrocardiography, which assesses the rhythm of heartbeats and detects the presence of cardiac arrhythmias. In order to diagnose insufficient mitral valve, a doctor inspects both atriums and ventricles with ECG.
- Phonocardiogram for mitral valve demonstrates the presence of systolic noise in the projection of valve.
- Echocardiography of the heart is the main method of determining the state of the mitral valve. It can also estimate the parameters of heart chambers and the thickness of its walls, the condition of the other heart valves and the presence of fluid in the pericardium.
- Prosthetic (replacement) of mitral valve (minimally invasive) is the most common type of surgery for this heart defect Generally, the replacement can be done by implanting either the biological prostheses (using aorta of animals) or mechanical valve (made of special medical alloys). Biological prostheses are mostly performed for women who plan on pregnancy in future and children, whose heart would not be able to get used to mechanical valve. After implantation of mechanical prosthesis patient requires constant administration of drugs, which can reduce blood clotting by blocking the synthesis of liver substances that create blood clots. After implantation of biological prosthesis the postoperative therapy takes only one or two months.
- Repair of mitral valve (minimally invasive) is a surgery, during which the mitral valve is constructed to pump out the blood properly.
- Mitral regurgitation is a surgery when an annuloplasty ring (plastic valve) in inserted into the heart at the base of the leaflets of the mitral valve. This ring supports the internal muscles of the heart, providing valve movement. Surgical treatment is contraindicated if there are irreversible comorbidities, which can lead the to death in the near future.