Mitral Valve Disease

Diagnosis

Diagnosis begins with a complete physical examination by a team of heart specialists. Patients will be asked about their general health, including signs and symptoms of potential problems, and whether their family has a history of heart disease. Tests listed below may be used to determine the possible cause of a heart valve defect, the severity of the problem, and whether the mitral valve must be surgically repaired or replaced. Specialists trained and experienced in the various diagnostic procedures perform these tests. Results of testing are usually available within a day in Mayo's state-of-the-art electronic medical record.

Chest X-ray

An X-ray image of the chest shows the physician the size and shape of the heart and whether the heart's left atrium (upper left chamber) and/or left ventricle (lower left chamber) are enlarged — a possible sign of a damaged mitral valve. By viewing a chest X-ray, the physician can also evaluate the lungs. A damaged mitral valve may result in blood backing up into the lungs. Congestion is visible on an X-ray.

Electrocardiogram (ECG)

Patches with wires (electrodes) are attached to the patient's skin to measure the heart's electrical impulses. These impulses are recorded as waves displayed on a monitor or printed on paper. An ECG provides information about heart rhythm and, indirectly, heart size. With mitral valve disease, the heart's left atrium (upper left chamber) and left ventricle (lower left chamber) may be enlarged, and heart rhythms may be irregular (arrhythmias).

Echocardiogram (Doppler Echocardiogram)

Sound waves produce detailed images of the patient's heart. Transmitted through a wandlike device (transducer) held on the patient's chest, sound waves bounce off the heart and are reflected back through the chest wall. The sound waves are processed to produce video images of the heart and a close look at the mitral valve. A Doppler echocardiogram may be used to measure the volume of blood flowing backward through the mitral valve.

Transesophageal Echocardiogram

During this test, somewhat similar to an echocardiogram, a tiny transducer (sound device) is inserted into the mouth and down the esophagus, which extends behind the heart. This test provides an even more detailed image of the mitral valve and blood flow through the valve.

Exercise Tests

Different exercise tests can help measure the patient's tolerance for activity and check the heart's response to physical exertion (exercise).

Cardiac Catheterization

A thin tube (catheter) is inserted into a blood vessel in the patient's arm or groin and threaded up to the heart. The catheter is used to deliver dye into the heart chambers and heart blood vessels. The dye, appearing on X-ray images as it moves through the heart, shows physicians detailed information about the heart and heart valves.

Catheters used in cardiac catheterization at Mayo Clinic have miniature devices (sensors) at the tips that can measure pressure within heart chambers.

Computed Tomography (CT)

A CT scan uses a series of X-rays to create a detailed image.

Magnetic Resonance Imaging (MRI)

An MRI uses powerful magnets and radio waves to create a detailed image.

Holter Monitor

A patient wears this portable device to record a continuous ECG, usually for 24 to 72 hours. Holter monitoring is used to detect intermittent heart rhythm irregularities that may be associated with mitral valve disease.

Electrophysiology (EP)

For patients with irregular heart beats, Mayo Clinic provides electrophysiology assessments. These tests are performed by electrophysiologists and cardiologists trained in the diagnosis and treatment of heart rhythm disorders, including those caused by heart valve defects. Mayo has the latest technology to analyze and record heart rhythms.

Other tests at Mayo Clinic use nuclear medicine (radioactive materials) for detailed imaging and advanced analysis of the heart and heart valves.