The aortic valve is the valve most likely to cause problems as we get older. But another valve, the mitral valve, can also cause trouble.
While mitral valve stenosis can occur in older people, it’s mostly a problem in younger people, usually caused by damage to the heart from rheumatic fever or other structural problems of the valve. Once you hit your 60s, the most common mitral valve problem is regurgitation. Mitral valve regurgitation is caused by leakage of blood backward through the mitral valve each time the left ventricle contracts. Chronic mitral valve regurgitation is the second most common reason for valve surgery in older adults.
Mitral valve regurgitation may not cause noticeable symptoms at first. But if the backflow becomes severe enough, it can cause fluid to build up in the lungs. Symptoms can include shortness of breath during exertion, coughing, and swelling of the feet and legs (edema). If regurgitation is severe enough, the heart muscle may enlarge in an attempt to maintain adequate forward flow of blood, but the enlargement of the heart itself can cause the flow to get even worse, leading to further heart failure.
If the problem continues to worsen, the valve may need to be replaced (as shown in photo).
This article first appeared in the August 2019 issue of UC Berkeley Health After 50.