What Are Mitral Valve Abnormalities?
The mitral valve is like a door in the heart that allows blood to pass from the left atrium (which receives blood from the lungs) to the left ventricle (which pumps blood out to the body). The mitral valve has two flaps or cusps.
Abnormalities of the valve can include:
- Mitral Valve Prolapse is when one or both valve flaps are enlarged. As a result, when the heart pumps, the mitral valve flaps don’t close smoothly and may not seal tightly. Instead, they may collapse backward into the left atrium. This sometimes causes regurgitation.
- Mitral Valve Regurgitation is when the mitral valve does not close well and blood leaks back into the left atrium from the left ventricle. This causes the atrium to get bigger. Then it cannot squeeze as effectively as it should.
- Mitral Valve Stenosis is when the valve becomes narrow or tight. This makes it hard for the blood to get through to the left ventricle. As a result, blood can back up in the blood vessels of the lungs. Stenosis can also cause regurgitation.
Mitral Valve Abnormalities in Children
Some children begin life with a normal mitral valve, and they develop problems later on. One cause is rheumatic fever, a problem with inflammation that can develop after an infection with Streptococcus bacteria.
Some children are born with mitral valve problems. The causes aren’t clear. Children born with mitral valve problems usually have other abnormalities that need to be treated:
- Congenital mitral valve leakage (regurgitation) often occurs with holes in the dividing walls between the upper or lower heart chambers.
- Congenital mitral valve narrowing (stenosis) is usually seen in association with other blood flow obstructions on the left side of the heart. Rarely, it can occur as an isolated condition.
- Sometimes children may have other health problems at birth, too. For instance, mitral valve prolapse sometimes occurs along with other conditions, like Marfan syndrome.
Some valve abnormalities don’t cause any problems. Some can cause serious problems, like heart failure, if they’re not treated.
Mitral valve abnormalities may cause no symptoms at all or none for many years. Your child may have some of these symptoms, depending on their valve problem and how severe it is:
- Feeling short of breath when active or laying down
- Coughing
- Feeling more tired than normal
- Having palpitations
- Having an arrhythmia
- Fainting or feeling dizzy
- Having chest pain
Mitral Valve Abnormalities Diagnosis
To diagnose a problem with the mitral valve, your doctor will examine your child. The doctor will use a stethoscope to listen for abnormal sounds in their heart, like a murmur or the sound of a valve not closing well. Sometimes doctors find valve problems after hearing a heart murmur in a child who appears well.
Your child will need an echocardiogram test so the doctor can see how their heart works. They may need other tests that provide more information about their heart. These include chest X-rays, exercise testing (also called stress testing), MRI (magnetic resonance imaging) of the heart, cardiac catheterization, or electrocardiogram.
Treatment for mitral valve abnormalities depends on the type of problem and how it affects your child.
Mitral valve prolapse
Most children with mitral valve prolapse don’t need treatment because their valve causes no symptoms or problems. If they do have symptoms, like palpitations or chest pain, they may need medicine to relieve these.
In uncommon cases, when a prolapsed valve causes major regurgitation, a child may need surgery to repair or replace the valve.
Mitral valve regurgitation
Depending on how severe it is, this valve problem may be treated with medicine that helps the left ventricle pump better so less blood leaks back into the left atrium (one of the atria). If medicine does not help enough, your child may need surgery to repair or replace their mitral valve.
Mitral valve regurgitation may lead to an arrhythmia. If this happens, your child may need medicines that help control their heartbeat.
Mitral valve stenosis
If mitral valve stenosis is not treated, blood pressure in the lungs may get too high. This is called pulmonary hypertension. It can cause permanent damage to the lungs and the heart, including heart failure.
To prevent damage, some children can have a balloon procedure to open their mitral valve. This is done in the catheterization lab. A balloon is inserted in the valve. When the balloon is inflated, the valve is stretched open. Then the balloon is removed. This is called balloon valvuloplasty.
Some children may need surgery to replace their mitral valve.
Patients with congenital valve disease are at risk for bacterial endocarditis, an infection of the heart’s valves or inner lining (endocardium.) Before having certain dental or surgical procedures performed, it may be necessary to take preventive antibiotics.
Source: Seattle Childrens Hospital