Acquired valvulopathy: mitral valve diseases

1. Big picture

Mitral valve disease mainly means mitral stenosis (MS), mitral regurgitation/insufficiency (MR), and mitral valve prolapse (MVP).

The examiner wants you to answer four things clearly:

1. What is the valve doing?

   • MS = valve does not open → obstruction from left atrium to left ventricle.
   • MR = valve does not close → systolic backflow from left ventricle to left atrium.
   • MVP = leaflet prolapse into left atrium; may cause MR.

2. What chamber suffers first?

   • MS → left atrium first.
   • MR → left atrium and left ventricle volume overload.

3. What is the key investigation?

   • Transthoracic echocardiography (TTE) with Doppler.

4. When is intervention needed?

   • Symptomatic severe MS → balloon commissurotomy or surgery.
   • Severe MR with symptoms or LV dysfunction → mitral repair/replacement; selected patients may undergo transcatheter edge-to-edge repair (TEER/MitraClip). Current ESC/EACTS and ACC/AHA guidance emphasizes Heart Team decision-making and early referral to valve centers for severe valvular disease. ([European Society of Cardiology][1])

---