Mitral Valve Disease

To diagnose mitral valve disease, including mitral valve stenosis and mitral valve regurgitation, a health care professional examines you and asks questions about your medical history.

The health care professional listens to your heart with a device called a stethoscope. A whooshing sound, called a heart murmur, may be a sign of a mitral valve condition.

Tests to diagnose mitral valve disease may include:

• Echocardiogram. Sound waves are used to create pictures of the heart in motion. This test shows how blood moves through the heart and heart valves, including the mitral valve. An echocardiogram can help in the diagnosis of congenital mitral valve disease, rheumatic mitral valve disease and other heart valve conditions.

  A standard echocardiogram is done from outside the body. But sometimes, a more-detailed echocardiogram is needed to get a closer look at the mitral valve. This type of echocardiogram is called a transesophageal echocardiogram. It is done from inside the body.

• Electrocardiogram (ECG or EKG). This quick and simple test measures the heart’s electrical activity. It shows how fast or how slowly the heart is beating. Sticky patches called sensors or electrodes are attached to the chest and sometimes the arms and legs. Wires connect the patches to a computer, which prints or displays results.
• Chest X-ray. A chest X-ray is a picture of the heart and lungs. It can show whether the heart is enlarged, which can be a sign of certain types of heart valve disease.
• Cardiac MRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. A cardiac MRI might be done to determine the severity of mitral valve disease.
• Exercise tests or stress tests. These tests often involve walking on a treadmill or riding a stationary bike while the heart is checked. Exercise tests help reveal how the heart responds to physical activity and whether valve disease symptoms occur during exercise. If you can’t exercise, you may get medicine that affects the heart like exercise does.

• Cardiac catheterization. A doctor guides a thin tube called a catheter through a blood vessel to an artery in the heart. Dye flows through the catheter. This makes the heart arteries show up more clearly on an X-ray.

  Cardiac catheterization isn’t often used to diagnose mitral valve disease, but it may be used if other tests haven’t diagnosed the condition. It also may be done to see if you have coronary artery disease.

Staging

After testing confirms a diagnosis of mitral or other heart valve disease, your health care team may tell you the stage of disease. Staging helps determine the most appropriate treatment.

The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs.

Heart valve disease is staged into four basic groups:

• Stage A: At risk. Risk factors for heart valve disease are present.
• Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms.
• Stage C: Asymptomatic severe. There are no heart valve symptoms, but the valve disease is severe.
• Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.