Diagnosing Mitral Valve Disease

At NYU Langone’s Heart Valve Center, our team of heart valve specialists works together to diagnose mitral valve disease. Your treatment may include robotically assisted mitral valve repair or minimally invasive mitral valve repair through our Mitral Valve Repair Program, or transcatheter-based treatments, including MitraClip^® procedures and transcatheter mitral valve replacement, through our Transcatheter Heart Valve Program.

Chronic mitral valve regurgitation typically progresses slowly. You may have no symptoms for years or decades. Some people receive a diagnosis after a physical exam reveals a heart murmur, in which sounds are heard that may indicate irregular blood flow through the heart.

Symptoms of mitral valve regurgitation include cough, fatigue, heart palpitations, shortness of breath, irregular heartbeat, and swollen ankles or feet. If the regurgitation is severe, it can lead to fluid buildup in the lungs and heart failure. These symptoms require immediate medical attention.

Often, people may have severe regurgitation but no symptoms. In these cases, the condition is diagnosed by an echocardiogram. This usually requires treatment to prevent the heart from enlarging or dilating. The major aim of treatment is to give the heart a better chance of returning to a normal size and function.

The other main type of mitral valve disease, mitral valve stenosis, may not cause any symptoms for decades. However, it can lead to chest pain, shortness of breath, an irregular heartbeat, and fluid buildup in the lungs. Exercise or activity may worsen symptoms. This condition is almost always caused by rheumatic fever during childhood. Other causes include calcification, in which calcium deposits form in the mitral valve as a person ages.

Diagnostic Testing for Mitral Valve Disease

After taking a medical history and conducting a physical exam, your NYU Langone specialist may recommend that certain tests be performed before making a diagnosis of mitral valve disease.

The following tests are used to help doctors diagnose mitral valve disease and determine the best treatment plan.

Echocardiogram

An echocardiogram is an ultrasound test in which sound waves create images of the heart’s chambers and valves. A gel is applied to your chest, and the technician uses a handheld device called a transducer to obtain the images.

Sometimes, a transesophageal echocardiogram is performed to provide clearer images of the heart. In this procedure, an ultrasound probe is inserted through your mouth and into the esophagus, which is the tube that carries food and liquids into your stomach. For this procedure, you are given sedation and a local anesthetic for the throat.

The echocardiogram remains the gold standard imaging technique for diagnosing and quantifying heart valve dysfunction.

Cardiac CT Scan

Your doctor may decide you need a cardiac CT scan. In a cardiac CT scan, advanced X-ray technology is used to create cross-sectional images of your heart. These images help your doctor better understand the cause of your symptoms, and often give your doctor the information needed to visualize the arteries, thus avoiding the need for additional tests.

NYU Langone uses the latest quick and safe CT scan technology. The dual-source CT scanner creates high-resolution diagnostic images with the lowest possible radiation exposure. We also use a special protocol that minimizes the amount of contrast dye needed, which is better for your kidneys.

Cardiac Catheterization

Cardiac catheterization can help your doctor measure the blood flow and pressure on both sides of the mitral valve. This helps the doctor detect problems with the valve’s ability to regulate blood flow through the heart. It is also used to detect blockages of arteries in the heart.

To perform the test, doctors insert a long, thin, hollow tube called a catheter into a blood vessel in the arm, neck, or groin. They use X-ray images to guide the catheter toward the heart.

The procedure is performed in the hospital and requires local anesthesia and sedation.