In most patients, mitral valve prolapse (MVP) produces no symptoms. However, some people experience mild symptoms such as fatigue, shortness of breath, or sharp chest pain. The symptoms of heart valve disease vary depending on the valve affected and how bloodflow is disrupted. Often, symptoms develop gradually as the heart becomes increasingly taxed from its extra workload; mitral stenosis, mitral regurgitation, aortic stenosis, and aortic regurgitation may take decades to produce symptoms. A small number of patients with mitral valve prolapse may also develop tachycardia (rapid heartbeats). If mitral valve prolapse causes substantial valve leakage (regurgitation), it may cause symptoms of congestive heart failure.
Mitral stenosis can cause shortness of breath with any sort of effort or activity, fatigue, and heart palpitations. In many people, symptoms don’t appear until the valve narrowing is severe. Shortness of breath is caused when the increased pressure needed to fill the left ventricle puts pressure on the blood vessels of your lungs. If your lungs have filled with fluid, you may cough up blood or bloody mucus. Some people also become quite hoarse if the pressure builds to the point where the left atrium presses on the nerves surrounding the vocal chords.
Mitral regurgitation can cause fatigue, palpitations, and shortness of breath. You may experience more severe symptoms depending on when the condition occurs. Because the left ventricle adjusts to the extra volume of blood being pumped by your heart, it may take years before you notice any symptoms. Whether or not mitral regurgitation is a long-standing problem or appears suddenly seems to dictate the type of symptoms you'll have. If your condition is mild, it’s common to have no symptoms at all. Over time, however, the leakage places extra pressure on your lungs, resulting in fatigue, palpitations, and shortness of breath with effort, when lying down, or during sleep. If mitral regurgitation comes on suddenly, it can cause severe shortness of breath at rest, and shock.
Aortic stenosis can cause chest pain that worsens with exercise or appears after exercise; fainting, and shortness of breath. These symptoms manifest as the condition worsens and the aortic valve becomes severely narrowed. Chest pain occurs because your heart has to pump harder to move the blood through the valve, creating a greater demand for oxygen than the blood can supply. Fainting is usually due to exertion; this causes your body's blood vessels to relax, lowering your blood pressure. In aortic stenosis, your heart isn't able to pump enough blood to offset this drop in blood pressure. Hence, bloodflow to your brain is reduced, causing you to faint.
As aortic regurgitation becomes severe, symptoms such as fatigue, dizziness, and shortness of breath with effort, when lying down, or suddenly during sleep will appear. You might also experience ankle swelling, or rarely, chest pain with exertion or when at rest. It’s also common to notice a pulse in the neck when lying on the left side, and heartbeats that feel premature.
Your risk for heart valve disease depends on a number of varying factors.
- Gender. Mitral valve prolapse occurs more often in women than men, possibly because a woman's mitral valve is naturally large in relation to the left ventricle. Conversely, aortic stenosis and aortic regurgitation affect more men than women.
- Age. Aging is a risk factor for aortic stenosis and mitral stenosis. This is because the natural buildup of calcium deposits on the leaflets that occurs as one ages can lead to stenosis. Aging also plays a role in mitral regurgitation.
- Rheumatic fever in childhood. Rheumatic fever in childhood is the most common risk factor for mitral stenosis.
- Genetics. Mitral valve prolapse tends to run in families. In addition, up to 1% of Americans are born with a bicuspid aortic valve, which is a major risk factor for aortic stenosis.
- Use of Phen-Fen. Prior use of this diet combination, which is now off the market, is associated with a greater risk for aortic or mitral regurgitation. In addition, having used the drug for more than four months appears to raise the risk for the development of valve disease.
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