Symptoms and causes
If you have difficulty with shortness of breath, problems climbing stairs and a rapid heartbeat, you could be suffering from mitral insufficiency. Or a disorder of the mitral valve, one of the heart valves. We also call this a “leaking mitral heart valve”.
Symptoms of a leaking mitral heart valve
The symptoms of a leaking mitral heart valve depend on how far the disorder has progressed. In many cases, a leaking mitral heart valve causes only slight or no symptoms at all. In the case of severe mitral insufficiency consider the following symptoms:
- Shortness of breath, particularly after exertion or when lying down
- A feeling of weakness and fatigue, mainly with increased activity (e.g. climbing stairs)
- Reduced appetite
- Brief loss of consciousness, your vision sometimes “goes black”
- Irritating cough, which becomes worse when lying down
- Heart palpitations, sensation of a rapid, fluttering heartbeat
- Fluid retention, swollen feet and ankles
- Having to urinate often at night
What precisely is Mitral Insufficiency?
Mitral valve insufficiency, mitral insufficiency or MI is a disorder of one of the heart valves, the mitral valve. The heart valves regulate the flow of blood through the four chambers of the heart. Each valve consists of a delicate, but stable tissue structure. When blood flows through the four heart chambers, the valves open and close and thus ensure that the blood flows in the correct direction.
The mitral valve is located between the left atrium and the left ventricle and works as a seal: it ensures that the blood flows forward through the heart with a normal heartbeat. If the mitral valve does not close completely, blood flows back in the opposite direction, or back into the atrium. We call this backflow mitral insufficiency.
Causes of leaking heart valve
A leaking mitral heart valve can have various causes, including:
- Deterioration of the valve tissue
- A congenital valve defect
- Heart conditions such as an infarction or other causes of a weakening of the heart muscle
Consequences of leaking heart valve
A leaking mitral valve places an additional load on the heart and lungs. Depending on how serious it is, a lesser or greater quantity of oxygen rich blood – that is actually destined for the organs – flows back to the atrium instead of circulating in the body. That has various consequences: as compensation for the quantity of blood lacking in the organs, some people develop an enlarged heart; in other words the heart has to work harder to pump blood through the body. However, over time this enlargement weakens the heart. The weakening of the heart leads to a reduction in heart capacity, shortness of breath upon exertion and congestion of the blood in the lung circulation path, which can lead to pulmonary edema, a life-threatening disorder. Because the blood flows back into the atrium there is also enlargement of the atrium. This can lead to heart arrhythmias (e.g. atrial fibrillation) or even a stroke. The body is able to compensate for a heart valve that does not close properly for a considerable period of time, without the patient necessarily noticing this. By the time symptoms do arise, the valve disorder is often already at an advanced stage. Severe mitral insufficiency is thus a progressive condition that should be diagnosed and treated in a timely manner to avoid the consequences mentioned above.
Your doctor can prescribe medicines that help to treat the symptoms of a leaking mitral heart valve. These medicines treat the symptoms, but do not remove the cause itself. You can be given the following medicines:
Diuretics are medicines that help your body to secrete excess fluid. The medicine stimulates your kidneys to produce more urine. Because of this the heart has to pump less fluid through the body and fluid buildup (edema), e.g. in the lungs or legs, is reduced.
Medicines that regulate blood pressure
Medicines that regulate blood pressure (e.g. ACE inhibitors or AT1 blockers) are used to make it possible for your heart to pump with less resistance. This takes the burden off your heart and less blood flows back.
Medicines that thin the blood
Blood thinners (anticoagulants or coagulation inhibitors) must reduce the risk of blood clots occurring. This protects against strokes. These often occur as a result of cardiac arrhythmias that can arise with mitral insufficiency.
Transcatheter Mitral Valve Repair (TMVr)
The doctor can recommend a Transcatheter Mitral Valve Repair treatment (percutaneous mitral valve reconstruction) if you meet certain criteria. The Transcatheter Mitral Valve Repair treatment is far less invasive compared to open-heart surgery. The cardiologists and heart surgeons who perform this procedure repair the leaking heart valve by attaching a special clip to the mitral valve. The clip ensures that the heart valve closes more effectively, which improves the normal blood flow through the heart.
How does the treatment work?
The Transcatheter Mitral Valve Repair is a type of clamp that is attached directly to the mitral valve without your chest having to be opened or you being attached to a heart-lung machine. To reach the mitral valve a flexible, long guiding catheter is inserted into an artery in the groin region and moved to the heart.
With the aid of this catheter, the clip is then attached to the mitral valve, after which it closes more effectively again. During the procedure the doctors can determine the position of the clip in the beating heart and, if necessary, adjust this as often as necessary to achieve the desired optimal reduction in insufficiency. The reduction in mitral insufficiency is verified with 3D-ultrasound images. You are under general anaesthesia during the operation.
Are you eligible for this treatment?
Transcatheter Mitral Valve Repair treatment is especially suitable for
- patients of advanced age
- patients with another condition in addition to heart disease
If you fall into (one of) the groups mentioned above, there is a high risk of complications with open-heart surgery. Transcatheter Mitral Valve Repair treatment will reduce your symptoms and is far less invasive, which might make it a good alternative for you. However, there are numerous criteria for each patient individually that determine whether the Transcatheter Mitral Valve Repair is a possibility. Only a doctor can determine whether Transcatheter Mitral Valve Repair treatment is the correct option for you.
Source with courtesy from leaky heart valve