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
Drowsiness
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.

Various stages of leaking mitral heart valve

The New York Heart Association (NYHA) classifies the degree of severity of a leaking mitral valve on the basis of physical capacity.