I think I have written in previous blogs about the fact that I have a leaky mitral valve. This can also be referred to as mitral valve regurgitation. Yes, I know - once again I am using another strange term that is chock full of consequences. So I probably need to do a short course on mitral valves and the concepts of regurgitation and prolapse.
Let’s start with the part of the heart that is at issue - what is a mitral valve? Well, according to the website cedars-sinai.org, the mitral valve is one of the heart’s four valves. These valves help the blood flow through the heart’s four chambers and out to the body. The mitral valve lies between the left atrium and the left ventricle. Normally, the mitral valve prevents blood flowing back into the left atrium from the left ventricle.
So the term mitral valve regurgitation might suggest to you that the valve has fallen down on the job and is not keeping the blood from flowing back. You would be correct. The cedars-sinai.org website indeed says that some blood leaks back through the valve. It doesn’t just flow forward into the ventricle the way it should. Because of this, the heart has to work harder than it should to get blood out to the body. If the regurgitation gets worse, some blood may start to back up into the lungs. A very small amount of mitral regurgitation is very common. However, a few people have severe mitral valve regurgitation.
So I think the last time I had an echocardiogram, it said that I have a moderate to severe mitral valve leak. You probably wonder if there is anything that works right in my heart. Trust me, I have often asked the same question.
Cedars-Sinai also says that mitral valve regurgitation can be acute or chronic. With the acute condition, the valve suddenly becomes leaky. In this case, the heart doesn’t have time to adapt to the leak in the valve. In the chronic form, the valve gradually becomes leakier. The heart has time to adapt to the leak. Symptoms with acute mitral regurgitation are often severe. With chronic mitral regurgitation, the symptoms may range from mild to severe
I remember that when I first learned about my mitral valve leak from my heart doctor, he said that I might be familiar with the term mitral valve prolapse. He said that this was a condition that is sometimes found in teenage girls.
So does the fact that I have a leaky mitral valve mean that it was caused by a valve prolapse? I am not a teenage girl, and in fact, didn’t even hear about my mitral valve till the age of 57. According to the Mayo Clinic, here are potential causes of mitral valve regurgitation: mitral valve prolapse; damaged tissue cords; rheumatic fever; endocarditis; heart attack; cardiomyopathy; trauma; congenital heart defects; certain drugs, such as those containing ergotamine (Cafergot, Migergot) that are used to treat migraines and other conditions; radiation therapy; and atrial fibrillation. So if I were a betting person, I’d bet that my leaky mitral valve was caused by my cardiomyopathy and not by mitral valve prolapse.
But while I doubt that I currently or have ever had mitral valve prolapse, this is a blog on heart issues. Because the mitral valve is in the heart, it makes sense that I should pursue the answer to the question: what is a mitral valve prolapse?
Before I provide an answer, I want to know if any of you even know what the term prolapse all by itself means? Bonus points if you can use it in a sentence that makes sense (other than a sentence like “A friend of mine has mitral valve prolapse. No takers? Then let’s move onto the medical definition.
According to the Mayo Clinic website, mitral valve prolapse occurs when the leaflets of the mitral valve bulge (prolapse) into the heart's left upper chamber (left atrium) like a parachute during the heart's contraction. Now this definition illustrates exactly why I just love to tease doctors. What a funky term to use, when there are so many other terms that are easier to understand and would make sense! For example, let’s look at the definition of the term prolapse found in the Collins English dictionary: the falling or slipping out of place of an internal organ, as the uterus. So why can’t they just say a slipped mitral valve, or a dislocated mitral valve?
Now that we have figured out what the term itself means, let’s revisit the Mayo Clinic definition, which I think contains another alarming disclosure: If a patient’s heart is racing, I would think that the last thing he or she wants is to be jumping out of a plane with a parachute? So how did this parachute get into the heart equation? Did the patient’s heart order something from Amazon? Should the patient file a fraud alert with his or her credit card company?
To make the whole matter even more confusing, the condition of mitral valve prolapse goes by other names, such as the following names I found on either the American Heart Association or other websites: click-murmur syndrome, Barlow's syndrome, billowing mitral valve syndrome, myxomatous mitral valve disease, or floppy valve syndrome. I have to ask who in their right mind would refer to it as myxomatous mitral valve disease? This term has the triple curse of being hard to spell, hard to pronounce and hard to remember. Geez – give the patient a fighting chance and just call the darn thing floppy valve syndrome. I think we can all spell, pronounce and remember that one!
But let’s be serious. Should you be concerned if you have mitral valve prolapse? According to the American Heart Association, the answer is: In most cases, it’s harmless. Most people who have the condition are unaware of it and their health is not affected. However, in some cases treatment is required. Again, since this is a blog about heart issues, I figure it is worth pursuing those infrequent instances that may require treatment, and how do you know if that instance is occurring in your heart.
So here is what the AHA tells you to be concerned about if you have mitral valve prolapse: People with an abnormal mitral valve may need mitral valve repair or replacement if symptoms are getting worse, the left ventricle of the heart is enlarged, or the heart function gets worse.
Once again, the AHA says that mitral valve prolapse rarely becomes a highly serious condition. However, in the most serious cases, mitral valve prolapse can cause abnormal heartbeats (arrhythmias) that may eventually become life-threatening. Also, when valve prolapse is severe enough to cause significant valve leakage, it can lead to serious complications like stroke. This happens because a mitral valve leaking (regurgitating) a significant amount of blood can cause blood clots to form. If clots travel from the heart to the arteries or the brain, it can lead to a stroke or heart attack.
Finally, the AHA has a great graphic guider called “Understanding Heart Valve Problems”. It features the various problems that can occur with your heart valves. The guider is interactive, and you can click on the bubbles to learn more about potential problems and potential resolutions. I’ll take helpful guides any day over a parachute!
Melanie discovered that she had heart failure in 2013. She spent the next 7 years learning how to live with the condition, and how to achieve balance and personal growth. Then in October 2020, she received a heart transplant. This blog is about her journey of the heart.