Non-Rheumatic Mitral Valve Insufficiency: Symptoms and Insights

What is non-rheumatic mitral valve insufficiency?

Due to experiencing left-sided chest pain for a period of time without improvement, I visited a cardiologist.
At that time, I mentioned that the pain was localized to a specific point, and the doctor indicated that it was likely not a heart issue because I am still young.
However, in my health insurance records, the doctor reported the symptom as "non-rheumatic mitral valve insufficiency." I would like to ask what this condition means.

Ms. Li, 30~39 year old female. Ask Date: 2021/07/20

Dr. Hong Yuanbin reply Internal Medicine

In the past, when medical knowledge was not as advanced, mitral valve insufficiency was often caused by bacterial infections, particularly streptococcal infections.
This type of infection is referred to as "rheumatic mitral valve insufficiency." Other causes that are not infection-related, such as congenital issues or hypertension, are collectively termed "non-rheumatic mitral valve insufficiency." Even today, if mitral valve insufficiency is detected without a specific identifiable cause, many physicians still tend to use the diagnosis of "non-rheumatic mitral valve insufficiency." Based on your age and description, it is likely that you have a higher chance of having congenital mitral valve insufficiency, which typically does not present with significant symptoms and may not require any specific treatment.
Thank you for your inquiry.

Reply Date: 2021/07/20

More Info

Non-rheumatic mitral valve insufficiency, also known as mitral regurgitation, is a condition where the mitral valve does not close properly, allowing blood to flow backward into the left atrium of the heart when the left ventricle contracts. This can lead to various symptoms and complications over time, depending on the severity of the condition.

Symptoms of Non-Rheumatic Mitral Valve Insufficiency
The symptoms of mitral valve insufficiency can vary widely among individuals. Some may experience no symptoms at all, especially in the early stages, while others may have significant discomfort. Common symptoms include:
1. Chest Pain: This can manifest as a sharp or dull pain, often localized to one area, which may be what you are experiencing. However, chest pain can have many causes, and it is essential to differentiate between cardiac and non-cardiac origins.

2. Shortness of Breath: This may occur during exertion or even at rest, particularly when lying down. It is due to fluid accumulation in the lungs as the heart struggles to pump effectively.

3. Fatigue: Individuals may feel unusually tired or weak, as the heart's inefficiency can lead to reduced blood flow to the body's organs.

4. Palpitations: Some may experience irregular heartbeats or a sensation of the heart racing.

5. Swelling: Fluid retention can lead to swelling in the legs, ankles, or abdomen.

Causes of Non-Rheumatic Mitral Valve Insufficiency
Non-rheumatic mitral valve insufficiency can be caused by several factors, including:
- Degenerative Changes: Age-related changes in the valve structure can lead to insufficiency.

- Ischemic Heart Disease: Damage to the heart muscle from reduced blood flow can affect the mitral valve function.

- Infective Endocarditis: An infection of the heart lining can damage the valve.

- Congenital Heart Defects: Some individuals may be born with structural abnormalities of the mitral valve.

Diagnosis and Management
Diagnosis typically involves a thorough clinical evaluation, including a physical exam and imaging studies such as echocardiography, which can visualize the valve's structure and function.
Management of non-rheumatic mitral valve insufficiency depends on the severity of the condition and the presence of symptoms. Options include:
1. Monitoring: If the condition is mild and asymptomatic, regular follow-up with a cardiologist may be sufficient.

2. Medications: Diuretics may be prescribed to manage symptoms of fluid overload, and other medications may be used to control blood pressure and heart rate.

3. Surgical Intervention: In cases of significant regurgitation with symptoms or evidence of heart dysfunction, surgical repair or replacement of the mitral valve may be necessary.

Conclusion
While your doctor has indicated that your symptoms are not likely related to a cardiac issue due to your age, the diagnosis of non-rheumatic mitral valve insufficiency should not be taken lightly. It is essential to continue monitoring your symptoms and maintain open communication with your healthcare provider. If your chest pain persists or worsens, or if you develop new symptoms such as shortness of breath or swelling, seek medical attention promptly. Understanding your condition can help you make informed decisions about your health and treatment options.

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It is advisable for you to discuss your condition further with your attending physician. Wishing you good health!