From an interview with
Dr. Ravi Parikh
McLeod Cardiology Associates Florence

The heart has four chambers, and each chamber has a valve to direct the flow of blood. When those valves become faulty, blood can leak or flow the wrong way.  McLeod Interventional Cardiologist explains the symptoms and treatments for a faulty Mitral Heart Valve.

Here’s a summary of Dr. Parikh’s comments:
Heart valve disease is actually a spectrum of diseases that involves any of the valves in the heart. The valves function as one-way doors to direct blood flow in one direction. Anytime you have either a valve that’s not opening well or is leaky it can be due to spectrum of diseases.

Valve disease can happen in adults of all ages and children, as well. However, our focus is adults, usually older people age 75 plus. It just depends on the underlying cause of the disease, but it can happen in anyone.

Mitral regurgitation refers to disease in the mitral valve where blood flows backwards, resulting in the heart working harder to push blood in the right direction, while a lot of it is going in the wrong direction.

The most common symptoms with mitral regurgitation are shortness of breath with exertion. When walking, doing day-to-day activity, you can have lower extremity swelling in your feet and ankles. You can have swelling in your belly. You can have decreased appetite. You can feel tired or fatigue. It’s a lot of different symptoms, but most commonly shortness of breath and swelling.

There are several options for people with mitral regurgitation, involving replacement of the valve or repairing the valve surgically. The other option is a catheter-based procedure through a blood vessel in the groin, using x-ray and ultrasound to deploy a device that clips the valve leaflets together.

The standard of care for people with valve disease due to wear and tear is surgery. For those who are not candidates for surgery, we have a minimally invasive device that can help them with a lot of their symptoms. In patients with congestive heart failure and mitral regurgitation because of an enlarged heart, the valve MitraClip procedure may be a better option than surgery.

Each of our patients is managed by an entire team of physicians, nurses, and care providers. The first step is the primary care doctor, who notices symptoms and orders further testing or refers the patient to a cardiologist. The cardiologist further evaluates the patient to try to medically manage them get them on right medications and then do other testing that’s necessary including an echocardiogram or sonogram of the heart to really look and understand the valve to determine the next steps. The next referral would be made to a structural heart team or a valve team, which consists of a surgeon and the interventional cardiologist. Usually, if the patient’s deemed a good candidate, they’ll go for surgery. If not, we along with the surgeons do the minimally invasive procedure together. So, it’s multiple people in a multi-step process to get the best result for the patient.

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