Mitral regurgitation is a disorder in which the heart valve that separates the upper and lower chambers on the left side of the heart does not close properly.
Regurgitation means leaking from a valve that does not close all the way.
Mitral valve regurgitation; Mitral valve insufficiency
Mitral regurgitation is the most common type of heart valve disorder.
Blood that flows between different chambers of your heart must flow through a valve. The valve between the two 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 leads to a decrease in blood flow 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, most often 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 and cause mitral regurgitation:
Risk factors include a personal or family history of any of the disorders mentioned above, and use of fenfluramine or dexfenfluramine (appetite suppressants banned by the FDA) for 4 or more months.
Symptoms may begin suddenly if:
There are often no symptoms. When symptoms occur, they often develop gradually, and may include:
When listening to your heart and lungs, the health care provider may detect:
The physical exam may also reveal ankle swelling, an enlarged liver, bulging neck veins, and other signs of right-sided heart failure.
The following tests may be done to examine the heart valve structure and function:
Cardiac catheterization may be done if heart function becomes worse.
The choice of treatment depends on the symptoms, and the condition and function of the heart.
Patients with high blood pressure or a weakened heart muscle may be given medications to reduce the strain on the heart and help improve the condition.
The following drugs may be prescribed when mitral regurgitation symptoms get worse:
A low-sodium diet may be helpful. If a person develops symptoms, activity may be restricted.
Once the diagnosis is made, you should make regular visits to your health care provider to follow your symptoms and heart function. Surgical repair or replacement of the valve is recommended if heart function is poor, the heart becomes larger (dilated), and symptoms become more severe.
People with abnormal or damaged heart valves are at risk for an infection called endocarditis. Anything that causes bacteria to get into your bloodstream can lead to this infection. Steps to avoid this problem include:
The outcome varies. Usually the condition is mild, so no therapy or restriction is needed. Symptoms can usually be controlled with medication.
Problems that may develop include:
Call your health care provider if symptoms get worse or do not improve with treatment.
Also call your health care provider if you are being treated for this condition and develop signs of infection, which include:
Treat strep infections right away to prevent rheumatic fever. Prompt treatment of disorders that can cause mitral regurgitation reduces your risk.
Otto CM, Bonow RO. Valvular heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 66.
Nishimura RA, Carabello BA, Faxon DP, et al. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52:676-685.