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Monday, May 25, 2009

Mitral Valve Replacement: Diagnosis and Treatements

Dr. Ganeshakrishnan Iyer, Consultant Cardio Vascular Surgeon, Wockhardt Hospitals shares his thoughts on " Mitral Valve Replacements"

The Mitral Valve is located between the left Atrium and the left ventricle of the heart. It acts as a one way door that allows blood flow from the left Atrium to the left ventricle and prevents it from flowing back into the chamber as the heart pumps blood through the Aorta to the rest of the body.

Damage to the Mitral valve affects the normal flow of blood from the lungs to the left Atrium and to the left ventricle. The blood may flow in a reverse direction back into the lungs which could lead to various respiratory problems and several other complications or there could be obstruction to the flow of blood from Left Atrium to Left Ventricle.

Causes of Mitral Valve Replacement

The causes for Mitral Valve Prolapse are classified into congenital and acquired. The acquired causes are categorized as: 1) rheumatic heart disease and 2) degenerative heart disease.

Rheumatic heart disease is a condition in which permanent damage to heart valves is caused by rheumatic fever. The heart valve is damaged by a disease process that generally begins with a strep throat caused by streptococcus a bacteria that may eventually cause rheumatic fever. Symptoms of rheumatic fever are fever, swollen, tender, red and extremely painful joints - particularly the knees, ankles, elbows, or wrists, nodules over swollen joints, red, raised, lattice-like rash, usually on the chest, back, and abdomen, uncontrolled movements of arms, legs, or facial muscles weakness and shortness of breath. The symptoms of rheumatic fever may resemble other bone disorders or medical problems. You need to consult your physician for a diagnosis.

Degenerative heart disease is the disease that has progressed gradually and that there is no specific event that has caused it.

Symptoms

The symptoms related to mitral valve failure progresses slowly, however in certain cases the patients don’t experience most symptoms until the disease is in an advanced stage, and there are also cases where the patient does not experience any symptoms at all.

The general symptoms include chest pains, shortness of breadth, difficulty in breathing, unusual heart heartbeat and fatigue.

Diagnosis

Diagnosis is often based firstly on the symptoms of the patient. A skilled doctor may detect a murmur in the heart beat during a regular health checkup. There are a number of tests that can help diagnose the disease.

Electrocardiograms (ECG) – gives a complete record of the electrical activities of the heart, any abnormalities of the electrical impulses of the heart shows up in this test
Echocardiograms – gives the doctor graphic representation of sound waves that are bounced of the heart to detect any abnormalities in the valves of he muscles of the heart.

Cardiac Catheterization – where a dye is injected into the blood stream and an x ray is taken that shows the direction of blood flow.

Treatment

Surgery to replace or repair the mitral valve is often the best option. However if the damage is beyond repair the total replacement is the only other option. Mitral valve replacement surgery is performed to replace the damaged or diseased valve with an artificial one. The artificial valve may be made of metal and pyrolytic carbon (Synthetic) or it may be derived form biological tissue (Biological).

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