Heart valve surgery can sometimes prevent heart failure symptoms.
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Mitral valve disease and heart failure often occur together. In some cases, mitral valve disease leads to heart failure symptoms, while in other cases, heart failure results in mitral valve dysfunction. The mitral valve allows oxygen-rich blood to travel from the top chamber of the heart -- the left atrium -- to the primary pumping chamber of the heart -- the left ventricle. From there, the left ventricle pumps blood to the rest of the body. When the heart's ability to pump blood is impaired by weakened heart muscle, heart failure ensues. Likewise, if the mitral valve becomes damaged, blood flow to the rest of the body may be compromised as well.
The Mitral Valve
Normal functioning of the mitral valve is essential for optimal blood flow to the body. The mitral valve consists of 2 leaflets of tissue that help control the flow of blood into the left ventricle. The mitral valve can be damaged by infection, degenerative changes, a heart attack or heart failure. In people with long-standing heart failure, the left ventricle tends to become dilated, or enlarged. As the ventricle grows larger, it stretches the mitral valve apart, and the valve becomes less effective at its job.
Mitral Valve Disease
Damage to the mitral valve can lead to a narrowing of the valve opening, called mitral stenosis, or a widening of the valve, known as mitral insufficiency. In some cases, mitral stenosis and mitral insufficiency occur together. Typical symptoms of mitral valve disease include shortness of breath, chronic cough, fatigue and swelling in the legs and feet. These symptoms reflect impaired blood flow to the rest of the body. According to research published in February 2011 in "Clinical Epidemiology," infection remains the leading source of mitral valve disease around the world. In the U.S., however, noninfectious causes, including heart failure, are more common.
Heart failure is characterized by the heart's inability to pump enough blood to meet the body's needs. High blood pressure, coronary artery disease, certain medications and substance abuse are frequent causes of heart failure. Mitral valve disease that is left untreated can also cause heart failure. In most cases, however, heart failure itself typically leads to mitral insufficiency. As heart failure progresses, the mitral valve gets worse at managing blood flow into the left ventricle. This process can make heart failure symptoms, like shortness of breath and swelling in the legs, even more severe. The author of a 2008 review article in the journal "Circulation" notes that mitral regurgitation, or insufficiency, associated with heart failure is linked to a worse prognosis than heart failure alone.
Because mitral valve disease symptoms and heart failure symptoms often overlap, it can be tough to determine which came first. Even so, mitral valve disease that is diagnosed early can generally be managed to prevent symptoms from progressing. The American College of Cardiology recommends that people who develop heart failure symptoms from mitral stenosis undergo surgery or a procedure called valvuloplasty to open up the narrowed valve. In cases of severe mitral insufficiency, surgical repair of the mitral valve is recommended before heart failure develops. People with severe mitral insufficiency who already have heart failure may also benefit from surgery, but the risk of complications is higher. Choosing a surgeon with specific expertise in mitral valve disease can greatly improve prognosis.