What Comes Next: Mitral Valve Disease
Making Sense of Your Diagnosis
Reviewed by Columbia Structural Heart and Valve Center Faculty, August 2025
Being diagnosed with mitral valve disease can leave you with a lot of questions. You may be wondering how serious it is, what treatments are available, and how your daily life might change. You're not alone—mitral valve disease is the most common type of heart valve disease.
Our What Comes Next series is designed to answer common questions and help you feel more informed and supported as you take the next steps.
I've Been Diagnosed With Mitral Valve Disease. How Serious Is It?
It depends on the type and severity of the disease. The mitral valve is one of four valves in the heart, and it helps control blood flow between the left atrium and left ventricle. When the valve doesn't work properly, it can disrupt blood flow and strain the heart. There are two main types of mitral valve disease:
- Mitral Regurgitation – when the valve doesn't close tightly, blood leaks backward into the left atrium.
- Mitral Stenosis – when the valve becomes narrowed or stiff and doesn't open fully, blood flow into the left ventricle is restricted.
Both conditions can be mild and manageable—or they can become serious over time if left untreated.
What Causes Mitral Valve Disease?
Mitral valve disease can develop for different reasons, including:
- Age-related degeneration (often called valve wear and tear)
- Rheumatic fever (less common in the US but still seen worldwide)
- Congenital valve defects (meaning you were born with it)
- Heart attacks or other heart conditions that affect heart muscle function
- Infections of the heart lining (endocarditis)
Sometimes, mitral valve disease is related to another condition that affects more than one valve or the heart muscle itself.
I Feel Fine. Should I Be Concerned?
Not necessarily—but you should be monitored closely. Some patients have no symptoms for years. But when symptoms do appear, they can include:
- Fatigue or shortness of breath
- Swelling in the legs or feet
- Irregular heart rhythms (especially atrial fibrillation)
- Chest discomfort or lightheadedness
- Reduced ability to exercise or be active
Even if you feel fine now, your cardiologist will likely recommend regular echocardiograms and check-ins to track your valve function and heart health.
Will I Need A Procedure?
Not always. Treatment depends on the severity of your condition, your symptoms, and how well your heart is functioning. In mild cases, medication and monitoring may be enough.
If your mitral valve disease is moderate or severe—and especially if it's affecting your daily life—your doctor may recommend mitral valve repair or replacement. This can often be done through minimally invasive surgical or transcatheter approaches, depending on your situation.
What Are the Treatment Options?
Depending on your diagnosis, you may be a candidate for:
- Medications – to reduce symptoms, control heart rhythm, or manage blood pressure
- Surgical Mitral Valve Repair or Replacement – through open-heart or minimally invasive/robotic techniques
- Transcatheter Edge-to-Edge Repair (TEER, also known by the brand name MitraClip) – a minimally invasive procedure used to repair a leaky valve, often without open surgery
- Transcatheter Mitral Valve Replacement (TMVR) – an emerging option for patients who aren't candidates for surgery
Your heart care team can help determine which treatment is right for you.
Can Medications Fix My Valve?
No—medications can help manage symptoms and slow the disease's progression, but they don't correct the structural problem with the valve itself. That's why regular follow-up is important: if the valve becomes more dysfunctional, a procedure may eventually be needed.
How Will I Know If It's Getting Worse?
Your doctor will use echocardiograms and other tests to monitor your valve and heart function. You should also let your care team know if you notice new or worsening symptoms, including:
- Trouble breathing when lying flat or during activity
- New swelling in your legs or abdomen
- Fatigue that feels out of proportion to your activity level
- New irregular or fast heartbeats
Early intervention can help prevent heart failure and preserve long-term heart function.
Will I Feel Better After Treatment?
Yes—most patients feel significantly better after mitral valve repair or replacement. Symptoms like shortness of breath and fatigue often improve quickly, and quality of life can return to a much higher level.
If you were living with heart failure before treatment, you may also notice improvements in those areas after your valve is fixed.
Will Treatment Help Me Live Longer?
Yes. Untreated moderate-to-severe mitral valve disease—especially with symptoms—can shorten lifespan and lead to heart failure or stroke. Treating the valve at the right time improves both survival and daily function.
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