Overview Of Mitral Valve Regurgitation
Mitral regurgitation is a disorder in which the mitral valve on the left side of the heart does not close properly.
Regurgitation means leaking from a valve that does not close all the way.
Causes Of Mitral Valve Regurgitation
Mitral regurgitation is a common type of heart valve disorder.
Blood that flows between different chambers of your heart must flow through a valve. The valve between the 2 chambers on the left side of your heart is called the mitral valve. When the mitral valve doesn’t close all the way, blood flows backward into the upper heart chamber (atrium) from the lower chamber as it contracts. This cuts down on the amount of blood that flows to the rest of the body. As a result, the heart may try to pump harder. This may lead to congestive heart failure.
Mitral regurgitation may begin suddenly. This often occurs after a heart attack. When the regurgitation does not go away, it becomes long-term (chronic).
Many other diseases or problems can weaken or damage the valve or the heart tissue around the valve.
You are at risk for mitral valve regurgitation if you have:
- Coronary heart disease and high blood pressure
- Infection of the heart valves
- Mitral valve prolapse (MVP)
- Rare conditions, such as untreated syphilis or Marfan syndrome
- Rheumatic heart disease. This is a complication of untreated strep throat that is becoming less common.
- Swelling of the left lower heart chamber
- Another important risk factor for mitral regurgitation is past use of a diet pill called “Fen-Phen” (fenfluramine and phentermine) or dexfenfluramine. The drug was removed from the market by the U.S. Food and Drug Administration (FDA) in 1997 because of safety concerns.
Symptoms
Symptoms may begin suddenly if:
- A heart attack damages the muscles around the mitral valve.
- The cords that attach the muscle to the valve break.
- An infection of the valve destroys part of the valve.
There are often no symptoms of mitral valve regurgitation. When symptoms occur, they often develop gradually, and may include:
- Cough
- Fatigue, exhaustion, and lightheadedness
- Rapid breathing
- A sensation of feeling the heartbeat (palpitations) or a rapid heartbeat
- Shortness of breath that increases with activity and when lying down
- Waking up an hour or so after falling asleep because of trouble breathing
- Urination, excessive at night
Exams & Tests
When listening to your heart and lungs, the health care provider may detect:
- A thrill (vibration) over the heart when feeling the chest area
- An extra heart sound (S4 gallop)
- A distinctive heart murmur
- Crackles in the lungs (if fluid backs up into the lungs)
The physical exam for mitral valve regurgitation may also reveal:
- Ankle and leg swelling
- Enlarged liver
- Bulging neck veins
- Other signs of right-sided heart failure
The following tests may be done to look at the heart valve structure and function:
- CT scan of the heart
- Echocardiogram (an ultrasound examination of the heart) – transthoracic or transesophageal
- Magnetic resonance imaging (MRI)
- Cardiac catheterization may be done if heart function becomes worse.
Treatment Of Mitral Valve Regurgitation
Treatment will depend on what symptoms you have, what condition caused the mitral valve regurgitation, how well the heart is working, and if the heart has become enlarged.
People with high blood pressure or a weakened heart muscle may be given medicines to reduce the strain on the heart and ease symptoms.
The following drugs may be prescribed when mitral regurgitation symptoms get worse:
- Beta-blockers, ACE inhibitors, or calcium channel blockers
- Blood thinners (anticoagulants) to help prevent blood clots in people with atrial fibrillation
- Drugs that help control uneven or abnormal heartbeats
- Water pills (diuretics) to remove excess fluid in the lungs
- A low-sodium diet may be helpful. You may need to limit your activity if symptoms develop.
Once the diagnosis is made, you should visit your provider regularly to track your symptoms and heart function.
You may need surgery to repair or replace the valve if:
- Heart function is poor
- The heart becomes enlarged (dilated)
- Symptoms get worse
