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Mitral valve regurgitation

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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.

egurgitation means leaking from a valve that does not close all the way.

Causes

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. !he valve between

the two chambers on the left side of your heart is called the mitral valve.

"hen the mitral valve doesn#t close all the way$ blood flows backward into the upper heart chamber %atriumfrom the lower chamber as it contracts. !his leads to a decrease in blood flow to the rest of the body. 's a

result$ the heart may try to pump harder. !his may lead to congestive heart failure.

Mitral regurgitation may begin suddenly$ most often after a heart attack. "hen 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(

•

)oronary heart disease and high blood pressure

• *nfection of the heart valves

• Mitral valve prolapse %M+P

• are causes$ such as untreated syphilis or marfan syndrome

• heumatic heart disease$ a complication of untreated strep throat %which is becoming less common

 because of effective treatment

• Swelling of the left lower heart chamber 

isk factors include a personal or family history of any of the disorders mentioned above$ and use of

fenfluramine or de,fenfluramine %appetite suppressants banned by the ' for / or more months.

Symptoms

Symptoms may begin suddenly if(

• ' heart attack damages the muscles around the mitral valve.

• !he cords that attach the muscle to the valve break.

• 'n infection of the valve destroys part of the valve.

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!here are often no symptoms. "hen symptoms occur$ they often develop gradually$ and may include(

• )ough

• atigue$ e,haustion$ and light-headedness

• apid breathing

• Sensation of feeling the heart beat % palpitations or a rapid heartbeat

• Shortness of breath that increases with activity and when lying down

• 0rination$ e,cessive at night

Exams and Tests

"hen listening to your heart and lungs$ the health care provider may detect(

• ' thrill %vibration over the heart when feeling the chest area

• 'n e,tra heart sound %S/ gallop

• ' distinctive heart murmur

• )rackles in the lungs %if fluid backs up into the lungs

!he physical e,am may also reveal ankle swelling$ an enlarged liver $ bulging neck veins$ and other signs of

right-sided heart failure.

!he following tests may be done to e,amine the heart valve structure and function(

• )! scan of the chest

• Echocardiogram %an ultrasound e,amination of the heart

• Magnetic resonance imaging %M*

)ardiac catheteri1ation may be done if heart function becomes worse.

Treatment

!he 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.

!he following drugs may be prescribed when mitral regurgitation symptoms get worse(

• Beta-blockers or ')E inhibitors

• Blood thinners %anticoagulants to help prevent blood clots in people with atrial fibrillation

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• rugs that help control uneven or abnormal heartbeats

• "ater pills %diuretics to remove e,cess fluid in the lungs

' low-sodium diet may be helpful. *f a person develops symptoms$ activity may be restricted.

2nce 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 functionis 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. 'nything that

causes bacteria to get into your bloodstream can lead to this infection. Steps to avoid this problem include(

• 'void unclean in3ections

• !reat strep infections 4uickly to prevent rheumatic fever 

• 'lways tell your health care provider and dentist if you have a history of heart valve disease or

congenital heart disease before treatment. 5uidelines recommend antibiotics for some patients$ but

only under certain conditions.

Outlook (Prognosis)

!he outcome varies. 0sually the condition is mild$ so no therapy or restriction is needed. Symptoms can

usually be controlled with medication.

Possible Complications

Problems that may develop include(

• 'bnormal heart rhythms$ including atrial fibrillation and possibly more serious$ or even life-

threatening abnormal rhythms

• )lots that may travel to other areas of the body$ such as the lungs or brain

• *nfection of the heart valve

• 6eart failure 

Wen to Contact a Medical Pro!essional

)all your health care provider if symptoms get worse or do not improve with treatment.

'lso call your health care provider if you are being treated for this condition and develop signs of infection$

which include(

• )hills

• ever 

• 5eneral ill feeling

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• 6eadache

• Muscle aches

Prevention

!reat strep infections right away to prevent rheumatic fever . Prompt treatment of disorders that can cause

mitral regurgitation reduces your risk.

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