Mitral Valve

What is a mitral valve?

The mitral valve is one of four valves in your heart. It’s located between your heart’s upper left chamber (left atrium) and lower left chamber (left ventricle). Your mitral valve opens and closes to make sure blood flows in the correct direction. The left atrioventricular valve is another name for it.

Your mitral valve is important because it lets oxygen-rich blood get to your left ventricle. Your left ventricle is the pump that pushes the blood out to your body so your tissues can get oxygen and nutrients.

You may not give much thought to your mitral heart valve until you have trouble with it. But it’s comforting to know that healthcare providers can offer a variety of treatments for mitral valve issues.

What does a mitral valve do?

Your mitral valve’s function is to open and close. Your heart pumps blood in a specific route through four chambers (two atria and two ventricles). As your heart pumps, valves open and close to allow blood to move from one area of your heart to another. The valves act as doors that open and close between the chambers. The sound of a heartbeat is the sound of your heart’s valves opening and then closing.

The valves help ensure that blood flows at the right time and in the correct direction. The function of your mitral valve is to make sure that blood flows from your left atrium to your left ventricle. It also ensures that blood doesn’t flow backward from your left ventricle to your left atrium.

Where is the mitral valve located?

Your mitral valve is located between the upper left chamber of your heart (the left atrium) and the lower left chamber (the left ventricle).

What are the parts of a mitral valve?

The main part of your mitral valve anatomy has two thin but strong tissue flaps (leaflets). Providers call them the anterior leaflet and the posterior leaflet. With every heartbeat, the leaflets open and close.

The leaflets attach to the papillary muscles of your left ventricle with thin, strong cords (chordae tendineae). There’s an area called the zone of coaptation that describes the portion of the leaflets that touch when the valve is closing. Maintaining a proper zone of coaptation is important to a well-functioning valve.

The leaflets also attach to the mitral annulus. The annulus is a D-shaped junction connecting the tissue of your left atrium to the tissue of your left ventricle.

What does a mitral valve look like?

You can picture something like a parachute when thinking about the anatomy of your mitral valve. Your mitral valve anatomy looks like two separate leaflets (one larger than the other) inside one saddle-shaped ring. When the two leaflets come together, they look like a closed-mouth smile. Your mitral valve has a diameter about as wide as a small paper clip.

The chordae tendineae look like strings of dental floss that connect the muscles below them to the leaflets above them. The papillary muscles and chordae tendineae work to move your valve’s leaflets.

What are the common conditions and disorders that affect a mitral valve?

When your mitral valve doesn’t function properly, your heart has to work harder to pump enough blood to the rest of your body.

It may not function properly because of:

• Age-related degeneration (wear and tear over time).
• A congenital (present at birth) valve abnormality.
• Damage to the valve or surrounding tissue (for example, from a heart attack).
• Infection and inflammation in the heart muscle, like endocarditis or rheumatic fever.
• Disorders that cause problems with the connective tissue in your body, like Marfan syndrome.
• Radiation to your chest for cancer treatment at a young age.

Your mitral valve can have a variety of different issues:

• Mitral valve prolapse: In mitral valve prolapse, the leaflets bulge backward into your left atrium. The valve can’t close properly and, over time, this can lead to regurgitation (leaking of the valve).
• Mitral valve regurgitation: With regurgitation, blood leaks and flows in the wrong direction. Your provider may classify mitral regurgitation as primary or secondary, depending on the cause of the regurgitation. Available treatments for primary and secondary mitral regurgitation can be different.
• Mitral valve stenosis: In stenosis, the valve becomes narrow or stiff and doesn’t open as much as it should. This can prevent enough blood from getting through the valve and into circulation.
• Double-orifice mitral valve: The valve may have a structural problem that produces more than one opening. At least one of the openings is usually narrow or leaky.

Common signs or symptoms of mitral valve conditions

A mitral heart valve condition may not cause any symptoms at all for many years. But it can get worse over time, so symptoms may appear as you get older. They may include:

• Heart murmur (an unusual sound when your heart beats), often the first sign of a valve problem.
• Dizziness.
• Fainting.
• Fatigue (feeling extremely tired).
• Chest pain.
• Heart palpitations (a fluttering or racing feeling in your chest).
• Shortness of breath (dyspnea) with exertion or when lying flat.

Serious mitral valve conditions may lead to life-threatening problems, like:

• Arrhythmia (irregular heart rhythm).
• Fluid buildup in your lungs.
• Heart failure.
• Pulmonary hypertension (high blood pressure in your lungs).
• Stroke.
• Cardiac arrest.

Because of these serious complications, it’s important to see your healthcare provider as soon as possible if you develop any signs of mitral valve issues.

Common tests to check the health of the mitral valve

Tests providers use to check your mitral valve’s health include:

• Auscultation (listening with a stethoscope).
• Echocardiogram.
• Electrocardiogram (EKG).
• Heart MRI (magnetic resonance imaging).
• Exercise stress test.
• Chest X-ray.
• Computed tomography (CT) scan.
• Cardiac catheterization.

What are the common treatments for the mitral valve?

The optimal treatment for mitral valve disorders depends on the type of problem. If you have issues with your mitral valve, your provider may treat them with:

• Medicine like diuretics or antihypertensives.
• Mitral valve commissurotomy.
• Mitral valve repair.
• Mitral valve replacement.

How can I keep my heart valves healthy?

You may not be able to prevent a mitral heart valve problem. But you can take action to help keep your heart healthier:

• Avoid smoking or using tobacco products.
• Avoid or limit caffeine and alcohol.
• Manage your stress level.
• Take care of your teeth and skin to prevent infections.
• Manage your blood pressure and cholesterol.
• Eat heart-healthy foods that are low in saturated and trans fats.
• Be physically active on most days of the week.

When should I seek medical attention?

If you have a mitral valve condition, it’s important to have regular checkups with your primary care provider or cardiologist. They’ll monitor your heart and lungs to detect any complications early and provide treatment. You should also take all your medications exactly as prescribed to prevent complications.

A note from Cleveland Clinic

If your mitral valve isn’t doing its job as well as it should, your heart may be working too hard. This can cause symptoms that a provider will need to treat. The good news is that many treatment options can ease the symptoms and prevent or delay complications. With today’s medical advances, treatment may be less invasive than you think. Take charge of your health and ask your provider about your options.