The condition in which blood leakage occurs in the heart through the mitral valve is known as mitral incompetence. To be exact, this valve is located on the left side of the heart between the atrium (upper chamber) and the ventricle (lower chamber). When mitral incompetence occurs, the mitral valve stops working in the proper way and it allows blood to flow back into the atrium as it does not get closed properly. Such a blood leak escalates blood pressure in the vessels leading to that particular chamber. As a result, the left side of the heart, where mitral valve is located, has to work harder so that it can pump blood to all parts of the body. This will eventually lead to chronic heart failure. In some cases, mitral incompetence can happen in combination with mitral stenosis.
It is found that occasionally, mitral incompetence can be present at birth itself. This occurs mainly due to a rare genetic disorder known as Marfan's syndrome. It is a known fact that any condition that is serious enough to cause mitral valve damage can eventually cause mitral incompetence. One among such causes was rheumatic fever. Even though this was once a very obvious cause for mitral incompetence, nowadays it is rarely detected in developed countries. This is mainly due to the extensive use of antibiotics. An infection of the valve is also another common cause for mitral incompetence (Refer Infective endocarditis). In addition to these a condition called hypertrophic cardiomyopathy may also distort the valve and cause incompetence. In this condition left ventricle wall gets thickened. This can happen also due to a heart attack in case the heart muscle close to that particular valve is affected (Myocardial infarction). In a few cases, mitral incompetence is also found to occur in combination with mitral valve prolapse.
Generally, mitral incompetence symptoms surface gradually. It may often take many months or years before they are completely surfaced. But, if this incompetence is caused by a heart attack or valve infection chances are that they will surface immediately. The common symptoms of mitral incompetence include:
· Feeling tired with no obvious reason.
· Shortness of breath while exerting oneself.
· Palpitations (being aware of irregular and abnormally quick heartbeats).
Sooner or later, chronic heart failure symptoms also may surface, like gasping for breath at rest other than during exertion. This often occurs because of fluid present in the lungs. Apart from that, swelling can also be observed at the ankles due to the fluid build-up in the body tissues.
The backward blood flow caused by the disease may cause the left atrium to get enlarged, causing irregular heartbeat (refer Atrial fibrillation). In case the atrium is too big and it becomes impossible for it to empty itself with each heartbeat there may be a chance of blood getting clotted. If such a clot forms in an artery supplying blood to the brain, it will result in a stroke. Another possible complication is when a leaky mitral valve gets infected after a dental treatment or a surgery on the urinary or digestive tracts.
Steps which can be taken
Heart murmurs often help your doctor for detecting mitral incompetence. As the next step, heart and lung function tests can be performed, together with an ECG and a chest X-ray. ECG helps to take images of the heart interior and confirm the diagnosis. It will also help us to monitor the movements of the mitral valve.
In case heart failure symptoms surfaces, diuretics drugs may be administered to relieve such symptoms. In case the left atrium gets enlarged, drugs that prevent blood clotting should be administered immediately so that the risk of getting blood clots in the atrium is minimized. In case of severe mitral incompetence, a valve surgery to get it repaired or a heart valve implantation/replacement is the only solution. In case you have a replaced or damaged heart valve, you should take antibiotics (often a single dose) before a dental treatment or a surgery on the urinary or digestive tracts.
Always keep in mind that mitral incompetence should always be tackled as early as possible before the heart gets damaged badly.