Mitral Valve Prolapse: Causes, Symptoms, and Treatments

Mitral valve prolapse is a disease wherein the leaflets or flaps of the mitral valve of the heart bulge (prolapse) like a parachute into the left atrium of the heart as it contracts during systole. It is also referred to as Barlow’s syndrome, Click-murmur syndrome, Floppy valve syndrome, Myxomatous mitral valve disease, or Billowing mitral valve syndrome. Sometimes, this prolapse can result in mitral valve regurgitation, a condition in which the blood starts to flow backward into the left atrium instead of the left ventricle. The turbulent blood flow or leaky heart valve results in the murmuring of the heart (a whooshing sound coming from the heart). Get the best care and treatment for mitral valve polapse with experienced heart surgeon in India Dr. Sujay Shad, (MBBS, MS, RCPS, FRCS (Cardiothoracic Surgery)). He is an expert in performing Cardiac Surgeries and Mitral Valve Repair in Delhi and supports his patients to get an improved quality of life.

What causes mitral valve prolapse?

In some cases it is caused due to heredity. It may also be linked to various other medical conditions, including:

• Muscular dystrophy

• Scoliosis

• Grave’s disease

• Marfan syndrome

• Ebstein anomaly

• Ehlers-Danlos syndrome

• Rheumatic heart disease, acute myocardial infarction, and hypertrophic cardiomyopathy that result in valvular structure damage and Secondary mitral valve prolapse.

 

What are the symptoms of Mitral Valve Prolapse?

Most individuals having mitral valve prolapse do not show any symptoms. Such people are advised to have some restrictions or limitations in their lifestyle, personal exercise, or daily diet. But some individuals may experience varied signs and symptoms. The most commonly occurring symptoms include:

Chest pain and discomfort: The pain felt in the chest is debilitating and occurs frequently.

Palpitations: People may have a sensation of rapid heart beating or fluttering of the heart. These are generally linked to the premature contraction of the ventricles but sometimes supraventricular rhythms (abnormal heart rhythm that start above the ventricles) may also be the reason.

Signs of heart failure: This includes fatigue (easy tiredness), weakness, dizziness, anxiety, and shortness of breath. The heart may fail due to the severity of the leakage of the blood into the left atrium during systole (i.e. because of mitral regurgitation). Some people may faint or pass out (called syncope) and also experience tingling or numbing sensations in the hands and feet.

 

How is Mitral Valve Prolapse treated?

Mitral valve prolapse is rarely a serious concern and does not require treatment (especially in people who have no symptoms). Moderate to severe cases of mitral valve prolapse leading to mitral valve regurgitation are recommended treatment either by medications or surgery. The best choice of treatment for the patient is determined by the doctor based on:

• General health and medical history of the patient

• The severity of the disease

• The expectations, preference, and opinion of the patient for the course of treatment

• The tolerance levels for specific procedures, therapies, or medications.

 

Some treatment modalities that work best for Mitral Valve Prolapse include:

Medications: Some prescribed medications include diuretics (to drain excess fluids from lungs), beta-blockers (to prevent irregular heartbeats by improving blood flow), anticoagulants and blood thinners (to minimize the risk of blood clotting), and heart rhythm medications (to normalize the heart’s electrical activity that contribute to arrhythmia).   

Surgery: Even if the symptoms of mitral valve prolapse appear or not in the patients but there is severe mitral valve regurgitation, surgery is recommended. In mitral valve prolapse surgery, the mitral valve is either replaced or repaired by performing open-heart surgery or by a minimally invasive procedure. 

During the surgery, Dr. Sujay Shad, cardiac surgeon in Delhi modifies the mitral valve of the patient by removing the extra valve tissues or by attaching a flappy valve tissue to stop the backward blood flow into the left atrium. A ring may also be reinforced around the valve of the heart to prevent mitral valve regurgitation. In case repair is not possible, an artificial mitral valve made up of human tissue or heart tissues of cows and pigs is used as a replacement for the damaged mitral valve. These mechanical valves can last longer for about 10 years or more by maintaining heart health.      

Transcatheter valve therapy: This is a less invasive approach for people who cannot undergo surgical repair or replacement in case of severe mitral valve regurgitation. In this therapy, the doctors make a small incision in the groin area through which an implant is inserted using a catheter shoved into a blood vessel present in the groin and guided to the heart. To know more about this life saving heart surgery consult Dr. Sujay Shad, best heart specialist in Delhi.  

Dr. Sujay Shad, best heart surgeon in India is an expert in performing various lifesaving surgeries like Heart Transplants, Coronary Bypasses, HOCM, Aortic Surgery, and Mitral Valve repairs and replacements. Get in touch for more information.

Coronary Bypass Heart Surgery - Dr. Sujay Shad

Coronary artery disease is a condition wherein the coronary arteries that supply oxygen-rich blood to the heart muscles get blocked or become narrow. It is caused by the build-up of plaque made up of either fatty material or calcium at the inside lining of the wall of the coronary artery. Coronary bypass surgery is one of the best treatment options for correcting coronary artery disease. Dr. Sujay Shad, Heart Specialist in Delhi, explains that undergoing coronary bypass surgery can ease the patient with symptoms like chest discomfort, palpitations, abnormal heart rhythm, and shortness of breath. It can also increase the chances of survival of the patient with better life quality. The surgery helps improve the blood supply to the heart muscles by redirecting the flow of blood around the section of the partially blocked or completely blocked coronary artery.

How to prepare for coronary bypass surgery?

Dr. Sujay Shad, heart doctor in Delhi, India gives a detailed explanation of the procedure to the patients, conducts a physical exam to check for their overall health, and review their medical history, before performing the surgery. He also gives certain instructions to the patients about any modifications in their diet and medications or restrictions in the physical activities before the surgery.

The patients must also inform the doctor about any allergies, current intake of medications, and any history of bleeding disorders during the consultation period or before undergoing surgery. For a healthy recovery of the patient, smoking, and drug or alcohol consumption must be avoided as soon as possible before the procedure commences.

Dr. Sujay Shad, specializes in performing lifesaving heart surgeries like Heart Transplants, Coronary Bypasses, HOCM, Aortic Surgery, and Mitral Valve at the Best Hospital for Heart Surgery, Sir Ganga Ram Hospital, located at Rajinder Nagar, New Delhi.

What to expect during coronary bypass surgery?

The coronary bypass surgery in Delhi involves the following steps:

• The anesthesiologist provides general anesthesia or intravenous sedation and continuously monitors the patient for vital signs like breathing rate, heart rate, blood pressure, and blood oxygen levels throughout the surgery. As the patient goes to sleep, a ventilator is connected to help him/her breathe during surgery. 

• A catheter is placed into the urinary bladder to drain all urine. 

• Next, the operation site is cleaned with an antiseptic solution to keep it sterile.

• The heart surgeon makes an incision in one or both legs or one of the wrists to take out the blood vessels to be used as a graft. After removal, the incisions are closed with sutures.

• Another vertical cut is made by the doctor in the mid-section of the chest extending to above the navel. The breast-bone (sternum) is also cut lengthwise into two halves to expose the heart. 

• Now the surgery may be performed using a heart-lung bypass machine or without it. In the off-pump procedure, the area around the diseased coronary artery is stabilized with a special instrument and the rest of the heart continues to function normally. For the on-pump procedure, the heart is stopped permanently and the blood is pumped using a heart-lung bypass machine. 

• In the bypass graft procedure, one end of the harvested blood vessel is sewed over a tiny opening made in the aorta and another end is attached to the coronary artery just below the blockage or narrowing of the artery. In some cases, an internal mammary artery may be used as a graft which requires only one end to be sewed to the opening of the coronary artery just below the blockage. 

• The patient may need multiple grafts based on how many blockages are there and what is their location. 

• The doctor closely examines the working of the bypass graft bypassing some blood through it.

• When all grafts are properly positioned and are in working condition, all the incisions made in the chest are closed using sutures. In the case of an on-pump procedure, the heart may either restart on its own after removing the heart-lung bypass machine or would require a mild electric shock for restoring the beating of the heart. Sometimes, the pacing of the heart may be done using a pacemaker device.

• After procedure completion, the surgeon inserts drainage tubes in the chest to take out extra fluids and blood from around the heart. 

• Lastly, a sterile dressing or a bandage is applied over the surgical site. 

Coronary arteries supply the heart with energy, nutrients, and oxygen. A blockage in these arteries can lead to cause a heart attack or other problems. Hence it is essential to keep the heart well supplied with blood. To know more about Coronary Artery Disease and Heart Surgery Cost in Delhi, schedule an appointment with the best heart specialist in India, Dr. Sujay Shad.