Causes and Effects Of Mitral Valve Disease
Done by… Hassan Mohammad Al-Shehri ID#2051040006
Introduction: Mitral valve disease Any disease of the mitral valve which is a heart valve that regulates the flow of blood between the two left chambers of the heart i.e. controls the flow of blood from the left atrium into the left ventricle of the heart. Some examples of mitral-valve diseases are mitral-valve prolapse, mitral regurgitation and mitral stenosis.
Mitral valve regurgitation Mitral valve is a condition in which the mitral valve doesn't close tightly, which allows blood to flow backward in your heart. When the mitral valve doesn't function properly, blood can't move through the heart or to the rest of the body as efficiently. Mitral valve regurgitation is also called mitral insufficiency, or incompetence. The condition can leave you fatigued and short of breath. Treatment of mitral valve regurgitation depends on the severity and progression of the condition and signs and symptoms.severe mitral valve regurgitation can lead to congestive heart failure or serious heart rhythm irregularities (arrhythmias).
Signs and symptoms Signs and symptoms of mitral valve regurgitation depend on how severely and quickly the condition develops. Most often mitral valve regurgitation is mild and develops slowly. Because you may have no symptoms for decades, you may be completely unaware that you have this condition. When signs and symptoms do develop, they may do so gradually because the heart is able to compensate for the valve defect for some time. Mitral valve regurgitation is often first suspected when the doctor hears a new heart murmur. Sometimes, however, the disorder develops quickly, and you may experience the abrupt onset of more severe signs and symptoms. Indicators of mitral valve regurgitation include: • • • • • • •
Shortness of breath, especially with exertion or when you lie down Fatigue, especially during times of increased activity Cough, especially at night or when lying down Heart palpitations Swollen feet or ankles Heart murmur Excessive urination
Causes Any condition that damages a valve can cause regurgitation. Mitral valve regurgitation has several causes, including: •
Mitral valve prolapse. Mitral valve prolapse is a condition in which the leaflets and supporting cords of the mitral valve weaken. The result is that with each contraction of the left ventricle, the valve leaflets bulge (prolapse) up into the left atrium. This common heart defect may prevent the mitral valve from closing tightly and lead to regurgitation. However, mitral valve prolapse is common and the vast majority of people who have it never develop severe regurgitation.
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Damaged cords. Mitral valve regurgitation may result from damage to the cords that anchor the flaps of the mitral valve to the heart wall. Over time, these cords may stretch or suddenly tear, especially in people with mitral valve prolapse. A tear of these cords can cause substantial leakage through the mitral valve and may require heart surgery to repair.
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Rheumatic fever. Rheumatic fever can damage the mitral valve, leading to mitral valve regurgitation later in life. Rheumatic fever can damage the mitral valve in two main ways. The infection may cause the leaflets of the valve to thicken, limiting the valve's ability to open. This results in narrowing of the valve, a condition known as mitral valve stenosis. The infection may cause scarring of the mitral leaflets leading to regurgitation. People with rheumatic fever, which is still common in countries where antibiotic use isn't common, may have both mitral valve stenosis and mitral valve regurgitation.
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Endocarditis. The mitral valve may be damaged by endocarditis
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Deterioration of the valve with age.
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Prior heart attack. A heart attack can damage the area of the heart muscle that supports the mitral valve, affecting the function of the valve. In fact, if the damage is extensive enough, a heart attack may result in sudden and severe mitral valve regurgitation.
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Congenital heart defects
Complications Mitral valve regurgitation puts you at risk of endocarditis. Typically, the infection involves one of the heart valves, especially if it's already damaged. If the mitral valve is damaged, it's more prone to infection than is a healthy valve. You can develop endocarditis when bacteria from another part of your body spread through the bloodstream and lodge in your heart When it's mild, mitral valve regurgitation may never pose a serious threat to your health. But when it's severe, mitral valve regurgitation may lead to these complications: 1- Congestive heart failure 2- Atrial fibrillation
Mitral valve stenosis Mitral valve stenosis is a condition in which the heart's mitral valve is narrowed. This narrowing blocks the valve from opening properly and obstructs blood flow between the left chambers of the heart. When the mitral valve is narrowed (stenotic), blood can't efficiently move through your heart and from the heart to the rest of the body The main cause of mitral valve stenosis is a childhood infection called rheumatic fever, which is related to strep infections. Rheumatic fever can scar the mitral valve. Mitral valve stenosis in people of all ages is treatable. Treatment depends on the severity and progression of your condition and your signs and symptoms. If the condition is severe enough, you may need heart surgery to repair or replace the valve.
Signs and symptoms • • • • • • •
Fatigue, especially during times of increased activity Shortness of breath, especially with exertion or when you lie down Swollen feet or ankles Heart palpitations Frequent respiratory infections, such as bronchitis Heavy coughing, sometimes with blood-tinged sputum Rarely, chest discomfort or chest pain
Causes Mitral valve stenosis is narrowing of the mitral valve. Many factors can tighten this passageway between the heart's left-sided chambers, obstructing blood flow into the heart's left ventricle. Causes of mitral valve stenosis include: •
Rheumatic fever. Rheumatic fever is the most common cause of mitral valve stenosis. It can damage the mitral valve in two main ways. The infection may cause the leaflets of the valve to thicken, limiting the valve's ability to open. Or the infection may cause the leaflets of the mitral valve to fuse somewhat together, preventing the valve from opening and closing properly. People with rheumatic fever may have both mitral valve stenosis and regurgitation.
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Congenital heart defect.
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Other causes. Rarely, growths, blood clots or tumors can block the mitral valve, mimicking mitral valve stenosis, excessive calcium deposits can build up around the mitral valve, which sometimes causes significant mitral valve stenosis.
Complications Whatever the cause, a narrowed mitral valve limits blood flow in the same way a narrow funnel spout limits the flow of fluid through a funnel. Pressure builds up in the left atrium, and the chamber may enlarge. Blood may back up into the lungs, leading to lung congestion and shortness of breath. In addition, the enlarged left atrium may become prone to atrial fibrillation mitral valve stenosis can lead to complications such as: •
Congestive heart pressure builds up in the lungs, leading to fluid accumulation. Eventually this places a strain on the right side of the heart, which leads to fluid buildup in either the ankles or abdomen or both areas.
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Heart enlargement. The pressure buildup of mitral valve stenosis results in enlargement of the heart's upper left chamber (atrium). At first this change helps the heart pump more efficiently, but eventually, it proves damaging to the heart's overall health. Additionally, pressure can build up in the lungs and cause pulmonary congestion and hypertension.
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Atrial fibrillation. In mitral valve stenosis, the stretching and enlargement of the heart's left atrium may lead to a heart rhythm irregularity called atrial fibrillation
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Blood clots. Left untreated, atrial fibrillation can put you at risk of blood clots forming in the upper left chamber of the heart, where blood pools in mitral valve stenosis. Blood clots from the heart may break loose and travel to other parts of the body, causing serious problems. For example, a blood clot that travels to the brain and blocks a blood vessel there could cause a stroke.
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Lung congestion. This causes congestion of the lungs, leading to shortness of breath and, sometimes, coughing up of blood-tinged sputum.