Diagnosis
The diagnosis begins with a detailed anamnesis (doctor-patient conversation) and a physical examination of the person concerned. The exact description of the symptoms can often provide the first indications for the diagnosis of the disease. Subsequently, the heart is typically listened to with a stethoscope (auscultation).
A mitral valve insufficiency here indicates a heart murmur, which is often sufficient for the trained examiner to make the suspected diagnosis. A sonographic examination (ultrasound) of the heart can either confirm or refute the suspected diagnosis of valve insufficiency. The ultrasound can be performed via a so-called “transesophageal echo” via the esophagus or from the front of the chest.
The ultrasound examination via the esophagus is colloquially known as swallowing echo. Furthermore, catheter examination of the vessels of the heart is often necessary for further therapy planning. In individual cases, imaging examinations with an MRT or CT may be useful.
The auscultation of the heart describes the listening of heart sounds and, if necessary, pathologically occurring heart murmurs with the aid of a stethoscope. An experienced physician can often make a tentative diagnosis of a relevant mitral valve insufficiency based on auscultation alone.The insufficiency of the valve causes a pathological flow noise, which occurs in the so-called systole (when the heart muscle contracts) and is characteristically loudest in the 4th or 5th intercostal space on the left side of the body. If the noise can also be heard in the armpit when listening, it is likely to be a mitral valve insufficiency.
Conservative therapy
The individual option for conservative therapy depends on a number of factors. On the one hand, it is relevant whether primary or secondary mitral valve insufficiency is involved. The degree of insufficiency also determines the possibility of conservative therapy.
Primary mitral valve insufficiency leaves little room for drug treatment and is therefore usually corrected by surgery. A secondary mitral valve insufficiency is caused by other heart diseases. In this case, therapy depends on the severity of the insufficiency and the underlying disease.
Thus, the best possible adjustment should always be made to the underlying disease at first. The administration of so-called ACE inhibitors, beta-blockers and spironolactones can be suitable therapeutic measures in the context of cardiac insufficiency that is additional to or has developed in the context of mitral valve insufficiency. While conservative therapy measures can be considered for mild and moderate mitral valve insufficiency, severe mitral valve insufficiency is usually treated surgically.
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