Mitral valve disease: symptoms, diagnosis and treatment

Consultant Cardiothoracic Surgeon, Joseph Zacharias, shines a spotlight on mitral valve disease and keyhole heart surgery.

What is mitral valve disease?

In your body, the mitral valve sits on the left-hand side of your heart between your left atrium and ventricle. It regulates blood flow from your lungs into your left ventricle. Mitral valve disease is an umbrella term used to describe two types of damage to this valve: stenosis and regurgitation.

Felt, red loveheart

Mitral valve stenosis occurs when the mitral valve in your heart is narrowed and does not open as widely as it should, restricting blood flow to the heart.

Meanwhile, mitral regurgitation is caused by mitral prolapse (when the valve becomes floppy and does not close tightly), which leads to blood flowing the wrong way in the heart.

What are the symptoms of mitral valve disease?

The first symptom of mitral valve disease is a murmur on the left-hand side of your chest. Your GP can identify this through a simple stethoscope check. Your doctor will then perform an echocardiogram test. This will confirm the severity of damage to your mitral valve.

Other symptoms might include:

  • Palpitations
  • Breathlessness
  • Dizziness
  • Swollen legs

However, any swelling mostly occurs at a later stage of mitral valve damage. It is also worth nothing that not all people experience symptoms with mitral valve disease.

What causes mitral valve disease?

This question is asked so frequently it deserves a Nobel Prize!

At the moment, we haven’t discovered why some people get mitral valve disease and others don’t.

Some patients struggle with it after they experience an infection of their heart valves. This leaves the valves inflamed and therefore more likely to become infected.

Does mitral valve disease always require surgery?

Thankfully, for many people who struggle with mitral valve disease the condition can be treated with medication.

This includes blood thinners and high blood pressure medications – but while medication treats mitral valve disease, it does not cure it.

Close-up of hands holding pills

If you suffer from stenosis or regurgitation, mitral valve surgery (sternotomy or endoscopic) is required to repair or replace the mitral valve in your heart. This can then cure mitral valve disease.

What is the difference between keyhole surgery and sternotomy?

Surgery to repair or replace your mitral valve can be performed by sternotomy or endoscopic (keyhole) surgery.


Sternotomy is a traditional approach to treating mitral valve damage.

To carry out the procedure, a surgeon will make an incision along your chest and partially clip or sew the flaps to reduce any blood leaking.

This method gives the surgeon wide access into the chest to perform the operation.

It has been performed for over 50 years and is considered a very safe approach, but it will leave a 9-12-inch scar on the front of your chest.

Some people are saddened by the prospect of a 9-12-inch scarring after surgery, while others are not as emotionally affected by this outcome – it’s entirely dependent on the individual.

Keyhole surgery

In keyhole (endoscopic) surgery, the aim is to perform the same operation without disturbing the bones of your chest.

During keyhole surgery, we use an endoscope to provide light and magnification to guide the procedure precisely.

We also use special instruments to help perform the procedure safely.

What are the risks of keyhole surgery?

The risks from keyhole surgery are similar to those associated with traditional open-heart surgery.

These risks include bleeding, stroke and infection. Risks associated with surgery are often related to your personal fitness levels.

Trainers with weights and healthy food

They are also impacted by the extent of damage to your heart valve.

What are the benefits of keyhole surgery?

Infection is less likely

You are less likely to develop an infection following keyhole surgery.

You will not lose much blood

You will lose less blood during and after keyhole surgery than an open-heart procedure.

Your recovery time will be faster

You do not have to wait for your breastbone to heal after keyhole surgery. As a result, the recovery period is much shorter.

Generally you will spend less time in intensive care and hospital after keyhole surgery, which can heighten its appeal for many people.

After three to four weeks, you would then be able to carry out most of your normal daily activities as by this point, scars are likely to have healed and pain won’t be an issue.

Of course, recovery time depends on your health and fitness levels prior to having surgery.

At the moment we are undergoing a research trial funded by NIHR (The National Institute of Health Research) to look into this topic and reach a definitive answer.

How can I take care of my heart?

There are many ways to take good care of your heart and decrease the likelihood of developing mitral valve damage.

This mostly includes implementing diet and lifestyle changes.

Close up of someone holding the sole of their trainers

If you are struggling with mitral valve disease, remember that keyhole surgery is a trusted treatment method and BMI Healthcare Consultants including myself are here and ready to help.

Read more: 5 tips for a healthy heart.

Need to speak to a Consultant about your heart? Call us on: 0808 101 0337, or make an online enquiry.

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