Description

Mitral valve regurgitation is the most common type of heart valve disease. In this condition, the valve between the left heart chambers, it is not closed completely. The blood leaks back through the valve. If the leak is severe, it is not enough that the blood moves through the heart or to the rest of the body. Mitral valve regurgitation can make you feel very tired or short of breath.

Other names for the regurgitation of the mitral valve are:

  • Mitral regurgitation (MR).
  • Mitral insufficiency.
  • Mitral incompetence.

The treatment of mitral valve regurgitation may include regular medical checkups, medications, or surgery. You may not need treatment if the disease is mild.

Severe mitral valve regurgitation often requires a catheter procedure or heart surgery to repair or replace the mitral valve. Without the proper treatment, severe mitral valve regurgitation can cause heart rhythm problems or heart failure.

Symptoms

Mitral valve regurgitation is often mild and develop slowly. Some people have no symptoms for many years.

But sometimes, mitral valve regurgitation develops quickly. When this happens, it's called acute mitral valve regurgitation.

Fatigue is common, but non-specific symptoms of mitral valve regurgitation. Other symptoms of mitral valve regurgitation include:

  • An Irregular heartbeat, called an arrhythmia.
  • Shortness of breath, especially when lying down.
  • Feelings of a fast, pounding, or fluttering heartbeat, called palpitations.
  • Swelling of the feet or ankles.

When to see a doctor

If you have symptoms of mitral valve regurgitation, make an appointment for a health checkup.

You may be referred to a doctor trained in diseases of the heart, called a cardiologist.

Causes

To understand the causes of the disease of the mitral valve, can be useful to know how the heart works.

The mitral valve is one of the four heart valves that keep blood flowing in the right direction. Each valve has flaps called leaflets that open and close once during each heartbeat.

In the regurgitation of the mitral valve, the valve flap is not closed tightly. The blood moves backward when the valve is closed. This makes it more difficult for the heart to work properly.

If the mitral valve regurgitation is due to problems with the mitral valve, the condition is called primary mitral valve regurgitation.

If a problem or illness which affects other areas of the heart because of a leak of the mitral valve, the condition is called functional or secondary mitral regurgitation.

Possible causes of mitral valve regurgitation include:

  • Prolapse of the Mitral valve. In this condition, the mitral valve of the fins of the bulge in the upper left chamber of the heart when the heart squeezes. This common problem of the heart can prevent the mitral valve from closing tightly and make the blood flow backwards.
  • Rheumatic fever. Rheumatic fever is a complication of untreated strep throat. Rheumatic fever can damage the mitral valve, leading to regurgitation of the mitral valve early or later in life. If the fever rheumatic causes the disease of the mitral valve, the condition is called rheumatic disease of the mitral valve. Rheumatic fever is rare in the united States.
  • Heart attack. A heart attack can damage the area of the heart muscle that supports the mitral valve. If there are plenty of heart attack damage, sudden and severe mitral valve regurgitation can occur. A leak of the mitral valve caused by a heart attack is called ischemic mitral regurgitation.
  • Problem of the heart that are present at birth, also called a congenital defect of the heart. Some people are born with heart problems related to the structure, including damaged heart valves.
  • The thickening of the heart muscle, called cardiomyopathy. Cardiomyopathy makes it harder for the heart to pump blood to the rest of the body. The condition can affect how the mitral valve works, causing regurgitation. Types of cardiomyopathy linked to the regurgitation of the mitral valve include dilated cardiomyopathy and hypertrophic cardiomyopathy.
  • The damaged cables. Over time, the pieces of the tissues that hold the flaps of the mitral valve of the heart of the wall of stretching or tearing. This is especially likely to occur in people with mitral valve prolapse. A tear can cause the blood suddenly to filter through the mitral valve. You can require surgical repair of the mitral valve. A chest injury can also cause the rupture of the cables.
  • Inflammation of the inner lining of the heart chambers and valves, called endocarditis. This condition is usually caused by an infection. The germs enter the bloodstream and attach to damaged areas in the heart.
  • The radiation therapy. Rarely, radiation therapy for cancer that focuses on the area of the chest can lead to mitral valve regurgitation.

Risk factors

There are several factors that can increase the risk of regurgitation of the mitral valve, including:

  • Certain infections that affect the heart.
  • Heart attack.
  • Problems with the heart present at birth, called congenital heart defects.
  • The history of other heart valve diseases, including prolapse of the mitral valve and mitral valve stenosis.
  • Advanced age.
  • The radiation in the chest.

Complications

Mitral valve regurgitation complications often depend on the severity of the disease. Mild regurgitation of the mitral valve usually does not cause any problem.

As mitral valve regurgitation, it gets worse, the heart must work harder to pump blood to the body. The strain on the heart can cause the lower left chamber to expand. The muscle of the heart may be weak.

Potential complications of severe mitral valve regurgitation include:

  • An irregular and often rapid heart beat, called atrial fibrillation. Mitral valve regurgitation can cause this heart rhythm disorder. Atrial fibrillation has been linked to an increased risk of blood clots and strokes.
  • High blood pressure in the lungs, called pulmonary hypertension. Long-term untreated or inadequately treated mitral regurgitation may increase the pressure in the blood vessels in the lungs. As the pressure increases, the fluid accumulates in the lungs.
  • Congestive heart failure. In the severe mitral regurgitation, the heart has to work harder to pump enough blood to the body. The extra effort that makes the lower left chamber of the heart larger. Without treatment, the heart muscle weakens. This can cause heart failure.

Diagnosis

To diagnose mitral valve regurgitation, a health professional will perform a physical examination and will ask you questions about your symptoms and medical history. A device called a stethoscope is used for listening to the heart and lungs. If you have mitral valve regurgitation, a whooshing sound called a bruit can be heard. The mitral valve heart murmur is the sound of blood leaking backward through the valve.

Tests may be done to confirm a diagnosis of mitral valve regurgitation, or to rule out other conditions that can cause similar symptoms.

Tests

Common tests to diagnose mitral valve regurgitation include:

  • The echocardiogram.Sound waves are used to create images of the beating heart. An echocardiogram shows the structure of the mitral valve and the blood flow in the heart. An echocardiogram standard is called a transthoracic echocardiogram (TTE). You can confirm a diagnosis of mitral valve regurgitation. The test you can also know how severe the condition is. Echocardiography can also help to diagnose congenital disease of the mitral valve by rheumatic mitral valve disease, and other conditions of the heart valves. Sometimes, a in more detail in the echocardiogram is necessary to get a better view of the mitral valve. This test is called a transesophageal echocardiogram (TEE). ATEEcreates images of the heart from the inside of the body.
  • Electrocardiogram (ECG). This test shows how the heart is beating. Sticky patches called sensors are connected to the chest and sometimes the arms and legs. The cables connect the patches to a computer, which displays or prints the results. An ECG may show irregular heart rhythms associated with mitral valve disease.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. This quick test can help to diagnose an enlarged heart and fluid in the lungs.
  • CardiacMRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. MRI can help to show the severity of the regurgitation of the mitral valve. The test also gives details on the lower left chamber of the heart.
  • Exercise tests or stress tests. These tests often involve walking on a treadmill or riding a stationary bike while the heart is on. Exercise tests show how the heart reacts to physical activity. The tests can show if the mitral valve regurgitation symptoms occur during the exercise. If you are unable to do exercise, you might be given a medication that causes the heart to work as exercise.
  • The cardiac catheterization. This test is not often used to diagnose the disease of the mitral valve. But it may be useful if other tests are not diagnosed with the disease. A doctor guides a thin, flexible tube called a catheter through a blood vessel in the arm or in the groin. Moves to an artery in the heart. Contrast medium flows through the tube. This causes the arteries in the chambers of the heart are shown more clearly on x-rays taken during the test.

The echocardiogram. Sound waves are used to create images of the beating heart. An echocardiogram shows the structure of the mitral valve and the blood flow in the heart. An echocardiogram standard is called a transthoracic echocardiogram (TTE). You can confirm a diagnosis of mitral valve regurgitation. The test you can also know how severe the condition is. Echocardiography can also help to diagnose congenital disease of the mitral valve by rheumatic mitral valve disease, and other conditions of the heart valves.

Sometimes, a in more detail in the echocardiogram is necessary to get a better view of the mitral valve. This test is called a transesophageal echocardiogram (TEE). A t-SHIRT creates images of the heart from the inside of the body.

Assay

After the test confirms a diagnosis of the mitral or other heart valve disease, your health care team can tell you that the stage of the disease. Staging helps to determine the most appropriate treatment.

The stage of heart valve disease depends on many things, including symptoms, severity of the disease, the structure of the valve or valves and the flow of blood through the heart and lungs.

Heart valve disease is staged in four basic groups:

  • Stage A: At risk. Risk factors for heart valve disease are present.
  • Stage B: Progressive. Valve disease is mild or moderate. No valve of the heart of the symptoms.
  • C-stage: Asymptomatic severe. No valve of the heart of the symptoms, but the disease of the valve is severe.
  • Stage D: Symptomatic severe. Heart valve disease is severe and is causing the symptoms.

Outlook

The prognosis of a person after being diagnosed with mitral valve regurgitation varies. This is the so-called outlook, also called the prognosis. The prognosis for mitral valve regurgitation depends on:

  • The cause of mitral valve disease.
  • The stage of the disease of the heart valve.
  • The severity of the regurgitation.
  • How long the condition has been present, also called the duration.

Treatment

The objectives of the mitral valve regurgitation treatment are:

  • Help the heart work better.
  • To reduce the symptoms.
  • To prevent complications.

Some people, especially those with mild regurgitation, you may not need treatment. Your health care team considers the symptoms and the stage of the regurgitation, among other things, in the planning of the treatment.

The treatment of mitral valve regurgitation may include:

  • Changes healthy lifestyle.
  • Regular medical checkups.
  • Medications to treat symptoms and prevent complications such as blood clots.
  • Surgery to repair or replace the mitral valve.

A medical doctor trained in heart disease usually provides care to people with mitral valve regurgitation. This type of health care professional is called a cardiologist.

If you have mitral valve regurgitation, consider the possibility of being treated at a medical center with a multidisciplinary team of health professionals trained and experienced in the assessment and treatment of heart valve disease.

Drugs

Medicines may be needed to reduce mitral valve regurgitation symptoms and prevent complications of the disease of the heart valve.

Types of medications that may be used for mitral valve regurgitation include:

  • Water pills, also called diuretics. This medicine reduces or prevents the accumulation of fluid in the lungs and other parts of the body.
  • Blood thinners, also called anticoagulants. If you have atrial fibrillation due to mitral valve disease, such as mitral valve regurgitation, your health care team may recommend these medications to prevent blood clots. Atrial fibrillation increases the risk of blood clots and strokes.
  • Blood pressure medications. High blood pressure causes the regurgitation of the mitral valve worse. If you have mitral valve regurgitation, and high blood pressure, you may receive medications to lower the blood pressure.

Surgery or other procedures

A diseased or damaged mitral valve, eventually, you might need to be repaired or replaced, even if you have no symptoms. Surgery for mitral valve disease includes the repair of the mitral valve and the mitral valve replacement. Your health care team will analyze the risks and benefits of each type of heart valve with you to determine that the valve may be best for you.

If you need surgery for another disease of the heart, a surgeon may perform the repair or mitral valve replacement at the same time that another surgery.

Mitral valve surgery is usually done through a cut in the chest. Surgeons at some medical centers sometimes use robot-assisted heart surgery, a minimally invasive procedure in which the robotic arms that are used to perform the surgery.

Repair of the Mitral valve

Repair of the Mitral valve keeps the existing valve and you can save the function of the heart. Whenever possible, repair of the mitral valve is recommended before considering the replacement of the valve. People who have mitral valve repair for mitral regurgitation in a medical center with experience in general have good results.

During the repair of the mitral valve surgery, the surgeon can:

  • Patch holes in a valve of the heart.
  • Reconnect the valve flaps.
  • Remove the excess valve tissue so that the flaps can be closed tightly.
  • The repair of the structure of the mitral valve by replacing the cables that support it.
  • Separate the valve leaflets that have been connected.

Another repair of the mitral valve procedures include:

  • Annuloplasty. A surgeon tense or reinforcing ring around the valve, called the annulus. Annuloplasty can be done with other techniques for the repair of a heart valve.
  • The valvuloplasty. This treatment is used for the repair of a mitral valve with a narrow opening. This can be done even if you have no symptoms. It makes use of a thin tube, called a catheter with a balloon at the tip. The surgeon inserts the tube into an artery in the arm or in the groin, and the guide of the mitral valve. The balloon is inflated, expanding the opening of the mitral valve. The balloon is then deflated, and the catheter and balloon are removed.
  • Mitral valve clip. In this treatment, a doctor guides a catheter with a clip on the end of the mitral valve through an artery in the groin. The clip is used to improve the closing of the leaflets of the mitral valve. Reduces the amount of regurgitation. This procedure is an option for people who have severe mitral valve regurgitation or are not good candidates for surgery of the mitral valve.

Mitral valve replacement

During the replacement of the mitral valve, the surgeon removes the mitral valve. It is replaced by a mechanical valve or a valve from a cow, pig or human heart tissue. A tissue valve is also called a biological tissue valve.

Sometimes, a heart catheter procedure is done to put a valve replacement in a biological tissue valve that is not working well. This is called a valve-in-valve procedure.

If you had mitral valve replacement with a mechanical valve, you need to take blood thinners for life, to prevent the formation of blood clots. Biological tissue valves will break down over time and need to be replaced.

Lifestyle and home remedies

Your health care team may suggest that you make several heart-healthy lifestyle changes. Take these steps:

  • Manage blood pressure. Control of high blood pressure is important if you have mitral valve regurgitation.
  • Eating a heart-healthy diet. Food does not affect directly the regurgitation of the mitral valve. But a healthy diet can help prevent other diseases of the heart, which can weaken the heart muscle. Eat foods that are low in saturated fats and trans fats, sugar, salt and refined grains such as white bread. Eat a variety of fruits and vegetables, whole grains, and protein, such as lean meats, fish, and nuts.
  • Get regular exercise. How long and hard you are able to exercise may depend on whether you have mild, moderate or severe mitral valve regurgitation. Talk with your health care team about the amount and type of exercise is best for you, especially if you are thinking about competitive sports.
  • Maintain a healthy weight. Being overweight increases your risk of heart disease. Talk with a health care professional to set realistic goals for body mass index and weight.
  • Prevent infective endocarditis. If you have had mitral valve replacement, your doctor will probably recommend that you take antibiotics prior to dental procedures to prevent an infection called infective endocarditis.
  • Avoid or limit consumption of alcohol. The excessive use of alcohol can cause irregular heartbeats and can make your symptoms worse. The excessive use of alcohol can also cause a weakening of the heart muscle that leads to mitral regurgitation. Ask your health care team about the effects of drinking alcohol.
  • Avoid tobacco. If you smoke, stop smoking. Ask your health care team about resources to help you quit smoking. Join a support group can be helpful.
  • Practice good sleep habits. Lack of sleep can increase the risk of heart disease and other chronic conditions. Go to bed and wake up at the same time every day, including weekends. If you have trouble sleeping, talk with a health professional about strategies that might help.

If you have mitral valve regurgitation and are thinking about becoming pregnant, talk with your health care team first. Pregnancy causes the heart to work harder. How a heart with mitral valve regurgitation tolerate this extra work depends on the degree of regurgitation and the way the heart pumps.

Preparing for your appointment

If you think you have mitral valve regurgitation, make an appointment to see a health professional. Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of pre-appointment restrictions. When you make the appointment, ask if there is something that you need to do beforehand.
  • Write down your symptoms, including any that seem unrelated to the regurgitation of the mitral valve.
  • Write important personal information, including a family history of heart disease, problems with the heart present at birth, genetic conditions, stroke, high blood pressure or diabetes, and any major stresses or recent life changes.
  • Make a list of all the medicines, vitamins, and supplements you are taking. Include the dose.
  • Have a friend or family member, if possible, to help you remember information that it receives.
  • Be prepared to discuss your diet and exercise habits. . If you do not eat well and exercise, be prepared to talk with your health care team about the challenges that you might face in the introduction.
  • Write questions to ask their health care team.

For the mitral valve regurgitation, some basic questions to ask a health care professional include:

  • What is probably the cause of my problem?
  • What are other possible causes of the symptoms?
  • What tests are needed?
  • What is the best treatment?
  • What other treatment options?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • If I need surgery, a surgeon who you recommended for the repair of the mitral valve?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your health care team is likely to ask many questions, including:

  • When did your symptoms begin?
  • Are your symptoms constant or come and go?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Mitral valve regurgitation