Mitral & Tricuspid Heart Valve Disease

Both mitral and tricuspid valve disease can be congenital (something you’re born with) or acquired (developing later in life) as a result of complications from a previous heart condition, infection (endocarditis), rheumatic fever or simply getting older.

What we treat

We treat people with all forms of mitral and tricuspid valve disease, including:

• Mitral regurgitation (leak).
• Mitral valve prolapse.
• Mitral stenosis (narrowing).
• Mitral valve dysfunction with atrial fibrillation (Afib).
• Tricuspid regurgitation.
• Tricuspid stenosis.
• Complex mitral or tricuspid valve disease, including calcified valves and previously repaired or replaced valves.
• Mitral or tricuspid valve disease combined with other conditions, like heart failure, pulmonary hypertension and congenital conditions.

The two most common types of mitral and tricuspid valve disease are stenosis (when the opening to your valve gets narrow or stiff) or regurgitation (when your valve doesn’t close completely and leaks). Mitral valve prolapse happens when the tissues of the mitral valve become abnormal and stretchy so that when the heart beats, the valve flops back into the left atrium. Mitral valve prolapse is the most common cause of a leaky mitral valve.

The symptoms of mitral or tricuspid valve disease can be subtle. You might be very tired, have swollen ankles or feel like your heart is skipping a beat. If the disease is farther along, you might have chest pain, shortness of breath or feel dizzy. You can also have heart valve disease for a long time and not feel any symptoms at all.

What to expect at your appointment

At your appointment, your healthcare provider will ask you about your medical history, your family medical history, what symptoms you’re having, and how severe they are. Your provider may also listen to your heart through a stethoscope. If your provider hears a murmur (abnormal whooshing sounds), that might mean there’s a potential blood flow problem in one of your heart’s valves. Not all murmurs are cause for concern, but it’s important to find out what’s causing the murmur and to monitor it.

If you have a heart murmur and/or experience any of the symptoms mentioned above, your provider may order diagnostic imaging tests to confirm a diagnosis. These tests may include:

• Echocardiogram (Echo): This test uses high-frequency sound waves (ultrasound) Ultrasound is delivered from a handheld wand on your chest to take pictures of your heart’s valves and chambers.
• Electrocardiogram (EKG): Your provider will put sticky electrode pads on your chest, arms and legs to measure your heart’s electrical activity.
• Computed tomography (CT scan): This test takes three-dimensional pictures of your heart to show how blood is flowing through your heart and blood vessels.
• Magnetic resonance imaging (MRI): An MRI uses powerful magnets and radio waves to take moving pictures of your heart as it’s pumping to see if there’s unusual blood flow through your heart.
• Cardiac catheterization (cardiac cath or angiogram): Your provider will put a small, flexible tube (catheter) into your leg or arm and pass it through a blood vessel to the inside of your heart to see if there are blockages in the heart’s arteries (the coronary arteries).
• Chest X-ray: A chest X-ray uses a focused beam of radiation to look at your heart.
• Exercise stress test: Your provider will have you walk on a treadmill or pedal a stationary bike while hooked up to an EKG machine to check your heart's activity when it’s working hard.

Plan on staying one to two days in the Cleveland area during the diagnosis process. You may need to stay longer if your provider schedules a treatment at the same time.

Your treatment will depend on the type of valve disease you have, how bad it is, your age, medical history and your family’s medical history. It will also depend on your goals — what you want to achieve with treatment. If you don’t have any symptoms, or your symptoms are mild, your provider may just keep an eye on your condition with regular checkups and testing. They may prescribe medications, such as diuretics (water pills), beta blockers and anticoagulants (blood thinners) to relieve mild symptoms, help your heart pump better and lessen the chance of more valve damage.

Minimally invasive and catheter-based procedures

If your valve is badly damaged, it may need to be repaired or replaced. Whenever possible, our providers use minimally invasive or robotically assisted procedures or catheter-based procedures that don’t require surgery at all. Options include:

• Minimally invasive mitral valve repair.
• Robotically assisted mitral valve repair.
• Percutaneous mitral balloon valvuloplasty (PMBV).
• Transcatheter MitraClip® mitral valve repair.

Open heart surgery

Sometimes mitral valve surgery or tricuspid valve surgery is needed. Your provider will let you know if this traditional approach is the best option. They’ll also tell you whether your valve can be repaired without using artificial parts or whether replacing it with a biological valve (from a cow or pig) or a mechanical valve (made from carbon and metal) is right for you.

Traveling for Heart Care at Cleveland Clinic

We know that traveling for any kind of healthcare can be stressful and intimidating. If you’re coming to us from another city, state or even another country, we’re here to help make things as easy and convenient as possible for you. From knowing where to stay and where to eat, how to get to and from the airport, shop, or just find your way around any of our hospitals, we’re here for you.

If you’re an international patient, our experienced and compassionate Global Patient Services (GPS) team will help you navigate the Cleveland Clinic health system. They’ll connect you with the healthcare providers you need, help make appointments, provide language translation services and coordinate follow-up care when you return home.

Taking the Next Step

When your heart is having problems, it’s very important to see a specialist right away. Small issues can lead to much bigger ones if a damaged heart valve is left untreated. It’s never too early to find out what’s going on. At Cleveland Clinic, you’ll get expert compassionate care from some of top experts in the field. You can feel confident knowing you’re in capable hands — from diagnosis to treatment to ongoing lifelong care.