Congenital mitral valve anomalies

• Narrowing of the mitral valve, also called mitral valve stenosis. The valve flaps are stiff. The valve opening may be narrowed. Mitral valve stenosis reduces blood flow between the left heart chambers.
• Leaky mitral valve, also called mitral valve regurgitation. The valve flaps don’t close tightly. Sometimes they push backward into the left upper heart chamber as the heart squeezes. As a result, the mitral valve leaks blood.

Symptoms of congenital mitral valve anomalies may be serious or mild. Serious symptoms in babies and young children may include:

• Shortness of breath during feedings.
• Poor weight gain.
• A pale gray or bluish tint to the skin. Depending on skin color, these changes may be easier or harder to see.
• Heavy breathing.
• A fast heartbeat.
• Swelling in the legs, belly or around the eyes.

Sometimes, symptoms of congenital mitral valve anomalies don’t appear until later in life, if at all. In older children and adults, symptoms may include:

• Trouble breathing, such as fast breathing or difficulty breathing during exercise.
• Chest pain or discomfort.
• Feeling very tired.
• Dizziness or fainting.
• Fast heartbeat or extra heartbeats

People with mitral valve anomalies also often have other heart conditions present at birth, which may cause other symptoms.

If you or your child has symptoms of heart valve disease, including congenital mitral valve anomalies, talk with a healthcare professional. You may be sent to a doctor trained in heart diseases, called a cardiologist.

The exact cause of congenital mitral valve anomalies is not known. The conditions happen when the unborn baby’s heart does not grow the way it should during pregnancy. An unborn baby also is called a fetus.

Gene changes, certain medicines or health conditions, and environmental or lifestyle factors, such as smoking, may play a role.

Things that may raise the risk of congenital mitral valve anomalies include:

• Smoking. If you smoke, quit. Smoking during pregnancy or exposure to secondhand smoke can harm the hearts of unborn babies.
• Alcohol use. Drinking alcohol while pregnant is linked to a higher risk of heart conditions present at birth such as mitral valve anomalies.
• Some medicines. Taking some medicines during pregnancy may increase the risk of congenital heart defects. Examples of these medicines are lithium (Lithobid) for bipolar disorder and isotretinoin (Claravis, Myorisan, others), which is used to treat acne. Angiotensin-converting enzyme (ACE) inhibitors for high blood pressure also can increase your risk. Talk with your healthcare team about the medicines you take.
• Rubella, also called German measles. Having rubella during pregnancy can cause harmful changes in a baby’s heart during pregnancy. A blood test done before pregnancy can determine whether you’re immune to rubella. A vaccine is available for those who aren’t immune.
• Diabetes. Careful control of blood sugar before and during pregnancy can reduce the risk of heart conditions in the baby. Diabetes that develops during pregnancy is called gestational diabetes. It generally doesn’t increase a baby’s risk of congenital heart defects.

If you were born with a heart condition, make an appointment for a health checkup with a doctor trained in treating congenital heart disease. Do this even if you aren’t having any complications. It’s important to have regular health checkups if you have congenital heart disease.

What you can do

When you make the appointment, ask if there’s anything you need to do in advance, such as avoiding food or drinks for a short period of time. Make a list of:

• Your symptoms, if any, including those that may seem unrelated to congenital heart disease, and when they began.
• Important personal information, including a family history of congenital heart defects and any treatment you received as a child.
• All medicines, vitamins or other supplements you take. Include those bought without a prescription. Also include the dosages.
• Questions to ask your healthcare team.

Preparing a list of questions can help you and your healthcare professional make the most of your time together. You might want to ask questions such as:

• How often do I need tests to check my heart?
• Do these tests require any special preparation?
• How do we monitor for complications of congenital heart disease?
• If I want to have children, how likely are they to have a congenital heart defect?
• Are there diet or activity restrictions I need to follow?
• I have other health conditions. How can I best manage these conditions together?
• Are there brochures or other printed material that I can have? What websites do you recommend?

Don’t hesitate to ask other questions.

What to expect from your doctor

Your healthcare team may ask you many questions, including:

• Do your symptoms come and go, or do you have them all the time?
• How bad are your symptoms?
• Does anything seem to improve your symptoms?
• What, if anything, makes your symptoms worse?
• What’s your lifestyle like, including your diet, tobacco use, physical activity and alcohol use?