How mitral valve disease is diagnosed?

• Using a stethoscope to listen for a heart murmur (the sound caused by the turbulent flow of blood passing through the heart).
• Having an electrocardiogram (ECG) to identify atrial fibrillation (an abnormal heart rhythm).
• Echocardiography (echo) to assess the severity of the stenosis and the size of the atrium.
• A chest X-ray to look for an enlargement of the atrium.
• Cardiac catheterisation (angiogram) to detect mitral regurgitation and stenosis. It is usually also carried out to detect any coronary artery disease.

Both medication and surgery may be needed.

The treatment will depend on how severe the symptoms are. Medication may be needed at first. The following medications are commonly used to relieve symptoms.

Diuretics or water tablets. These encourage the body to produce urine to relieve the build-up of fluid in the lungs and lower part of the body.

• ACE inhibitors. These reduce the amount of work the heart does and improve the flow of blood to the heart muscle.
• Anti-arrhythmic drugs. These stabilise the heart rhythm.
• For atrial fibrillation, warfarin may be necessary to prevent the blood from clotting.
• Antibiotics will be necessary to treat infective endocarditis.

If surgery is needed, mitral valve may be repaired or replaced depending on your medical condition.

Mitral regurgitation is also called mitral insufficiency or mitral incompetence. Regurgitation of the mitral valve arises when the valve is weakened or damaged. The valve cannot close properly and causes the blood to leak (regurgitate) back from the left ventricle into the left atrium.

As the valve’s ability to close properly worsens, more blood leaks back into the left atrium. This puts pressure and strain on the atrium. In time the wall of the atrium becomes thickened and enlarged. The enlargement also causes atrial fibrillation, an abnormal rhythm of the heart.

Mitral regurgitation is usually caused by:

• Infection of the inner lining of the heart;
• Injury to the mitral valve following a heart attack;
• Valve damage caused by rheumatic fever during childhood; or
• The structures of the valve weakening with age.

The symptoms of mitral regurgitation can come on suddenly after an infection or heart attack, or may progress slowly over time.

As the disease progresses, the left side of the heart works less efficiently. The following symptoms may arise.

• Shortness of breath when active
• Palpitations or an irregular heart rhythm
• Fainting or dizziness

Chest pain or angina is also a common symptom and is caused by the thickened ventricle needing more oxygen and because of insufficient blood flow to the coronary arteries.