The heart is a two-sided pump with four chambers. Four valves control the flow of blood through the heart. The mitral valve sits between the left atrium (upper chamber) and the left ventricle (lower chamber), and is the first valve on the left side of the heart.
A normal mitral valve is made up of two thin leaflets. This valve opens to allow blood to flow from the left atrium into the left ventricle, and closes to keep blood from leaking back into the atrium.
Sometimes a baby is born with a defective mitral valve. In other cases during childhood or adulthood, certain heart or health problems can lead to a weakened mitral valve. Problems with the mitral valve include:
Symptoms vary widely depending on the type and severity of the condition.
A newborn with severe or critical mitral stenosis may require treatment immediately. Symptoms may include:
In less severe cases, symptoms may include:
Mitral valve regurgitation can also cause these symptoms. Sometimes these symptoms don’t appear until the child is older or is an adult.
Rheumatic fever, an acquired disease, can cause scarring in the heart tissue resulting in mitral stenosis or regurgitation; symptoms may not appear until many years after the child has the disease.
Mitral valve prolapse often has no symptoms. In some cases mitral valve prolapse causes arrhythmias (abnormal heart rhythm).
Often a pediatrician will hear a heart murmur (an extra heart sound) and refer the child to the Cardiac Center.
Echocardiography (sound waves create an image of the heart) will be used to make a diagnosis. Diagnosis may also include:
Treatments vary widely depending on the type and severity of the condition. In many cases, no treatment is necessary. In other cases, the child may need to take medications.
In severe cases, treatment options include:
A child who was born with mitral stenosis will require follow-up care. He will need to visit a pediatric cardiologist for evaluation and testing to ensure that there is no worsening of the obstruction at the valve. Children who have had a mechanical valve surgically placed will need routine monitoring to make sure that the blood thinner is creating just the right amount of thinning effect.
Depending on the severity of the condition and the symptoms, children with mitral regurgitation or mitral valve prolapse may or may not require follow-up visits with a pediatric cardiologist. We will discuss follow-up care with you based on your child’s unique needs.
For those children who will require care from a cardiologist for their whole lives, we will help them transition from a pediatric cardiologist to an adult congenital heart disease specialist.
The Philadelphia Adult Congenital Heart Center, a joint program of The Children’s Hospital of Philadelphia and the University of Pennsylvania, meets the unique needs of adults who were born with heart defects.
Contact the Cardiac Center at The Children's Hospital of Philadelphia for a second opinion or for more information.
Reviewed by: Jeffrey R. Boris, MD
Date: March 2010
For a second opinion, cardiac referral, or for more information.
To schedule an outpatient appointment.