If the mitral valve does not close completely, the blood that has already passed from the left atrium to the left ventricle may return to the left atrium. Because of this, the heart needs to work more intensely to push out the blood that is accumulated in the left atrium. The heart wall expands to overcome the additional burden. This condition is known as mitral insufficiency. Usually, the cause of this is a rheumatic fever, but the mitral insufficiency is sometimes inherent, although it may also be acquired (it develops later in connection with some other cardiac disease).
There are often no symptoms, but in case they occur the symptoms are loss of breath, exhaustion and symptoms of cardiac decompensation. A patient may have problems with swallowing because an enlarged wall of left atrium can exert pressure on the esophagus.
Mitral insufficiency can be permanent if the valve is damaged, or temporary as in the case of acute stage of rheumatic fever. However, since the number of people who suffer from rheumatic fever has decreased in recent years, mitral insufficiency as a result of rheumatic fever is not as common as before.
Dangers are similar to the dangers of mitral stenosis. In fact, these two disorders often occur together. People who are suffering from mitral insufficiency but without mitral stenosis are less prone to atrial fibrillation. However, they are more prone to bacterial endocarditis.
What to do?
Contact your doctor if you have any of these symptoms, especially if you are having problems while swallowing. The doctor will listen to your heart with a stethoscope and probably refer you to other tests, such as an X-ray of the chest and electrocardiogram (EKG).
If there are no symptoms, treatment, as in the case of mitral stenosis, will probably not be necessary. However, if you have a mitral insufficiency, be sure to take antibiotics before the tooth extraction or any surgery. In this way, you will be ”armed” against the dangers that threatens you from bacterial endocarditis. Treatment of mitral insufficiency is largely the same as the treatment of mitral stenosis. If you have very pronounced symptoms, your doctor will recommend surgery to replace the diseased valve with an artificial.
Today, there are two types of replacement: with an artificial valve and a valve from transplanted tissue. The surgeon will judge what is appropriate in your case. A replacement with an artificial valve is effective, but in some people (5-10% of all cases) it causes blood clots. If you have artificial valve, you will have to take anticoagulants against this complication. Anticoagulants are not suitable for people with a stomach ulcer or duodenal ulcer (becase they – ulcers – can bleed) or for those who live far away from laboratory devices essential to monitoring such treatment. Valves from the transplanted tissue are less dangerous in terms of blood clotting, but it seems that they do not work as reliable as artificial valves.
Approximately 80% of the operated patients live with active life at least five years after the operation. If, at any time after the surgery, you suddenly feel like you are losing your breath or if you have dizziness, contact your doctor as soon as possible. Any of these symptoms can alert you to the mechanical error of the replaced valve.