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Chronic mitral regurgitation is a long-term disorder in which the heart's mitral valve does not close properly, causing blood to flow backward (leak) into the upper heart chamber when the left lower heart chamber contracts. The condition is progressive, which means it gradually gets worse.
See also: Acute mitral regurgitation
Alternative NamesChronic mitral valve regurgitation; Mitral valve insufficiency
Causes, incidence, and risk factorsMitral regurgitation is the most common type of heart valve insufficiency. After age 55, some degree of mitral regurgitation is found in almost 20% of men and women who have an echocardiogram.
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.
Regurgitation refers to leaking from a valve that doesn't close all the way. Diseases that weaken or damage the valve or the heart tissue around the valve cause mitral regurgitation.
When the mitral valve doesn't close all the way, blood flows backward into the upper heart chamber (atrium). 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 chronic (long-term).
Mitral valve prolapse (MVP) is a relatively common cause of chronic mitral regurgitation. However, most patients with MVP do not develop severe mitral regurgitation.
One out of three cases of chronic mitral regurgitation are caused by rheumatic Heart disease, a complication of untreated strep throat that is becoming less common.
Congenital (present from birth) mitral regurgitation is most often part of a more complex heart defect or syndrome.
Common causes of chronic mitral regurgitation include:
- Coronary artery disease and heart attacks
- Endocarditis
- Heart tumors
- High blood pressure
- Marfan syndrome
- Swelling of the left lower heart chamber
- Untreated syphilis (rare)
Risk factors include an individual 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.
SymptomsThere are often no symptoms. When symptoms occur, they often develop gradually, and may include:
- Cough
- Fatigue, exhaustion, and light-headedness
- Palpitations(related to atrial fibrillation)
- Shortness of breath during activity and when lying down
- Urination, excessive at night
The doctor may detect a thrill (vibration) over the heart when feeling the chest area. An extra heart sound (S4 gallop) and a distinctive heart murmur may be heard when listening to the chest with a stethoscope. However, some patients may not have this murmur. If fluid backs up into the lungs, there may be crackles heard in the lungs.
The physical exam may also reveal ankle swelling, enlarged liver, distended neck veins, and other signs consistent with right-sided heart failure.
The following tests may be done:
- Cardiac color-Doppler study
- Cardiac catheterization
- Chest x-ray
- CT scan of the chest
- ECG
- Echocardiogram(an ultrasound examination of the heart)
- Magnetic resonance imaging (MRI)
- Radionuclide scans
- Transesophageal echocardiogram (TEE)
The choice of treatment depends on the symptoms present 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.
Anticoagulant or antiplatelet medications (blood thinners) may be used to prevent clots from forming in patients with atrial fibrillation.
Digitalis may be used to strengthen the heartbeat, along with diuretics (water pills) to remove excess fluid in the lungs.
A low-sodium diet may be helpful. Most people have no symptoms; but if a person develops symptoms, activity may be restricted.
Hospitalization may be required for diagnosis and treatment of severe symptoms. Surgical repair or replacement of the valve is recommended if heart function is poor, symptoms are severe, or the condition gets worse. Once the diagnosis of mitral regurgitation is made, you should have regular follow-ups with a specialist to determine whether you need surgery.
In the past, patients with heart valve problems such as mitral regurgitation were given antibiotics before dental work or an invasive procedure, such as colonoscopy. The antibiotics were given to prevent an infection of the damaged heart valve. However, antibiotics are now used much less often before dental work and other procedures.
Expectations (prognosis)The outcome varies based on the underlying conditions. Usually the condition is benign, so no therapy or restriction is necessary. Symptoms can usually be controlled with medication. In severe cases, valve repair or valve replacement may be needed.
Complications- Arrhythmias(abnormal heart rhythms), including atrial fibrillation and lethal arrhythmias
- Clots to other areas
- Endocarditis (infection of the heart valve)
- Heart failure
- Pulmonary emboli (blood clots in the lungs)
- Stroke
Call your health care provider if you have symptoms of mitral valve regurgitation, or if symptoms worsen 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:
- Chills
- Fever
- General ill feeling
- Headache
- Muscle aches
Treat strep infections promptly to prevent rheumatic fever. Prompt treatment of disorders that can cause mitral regurgitation reduces your risk.
Any invasive procedure, including dental work and cleaning, can introduce bacteria into your bloodstream. The bacteria can infect a damaged mitral valve, causing endocarditis. Always tell your health care provider and dentist if you have a history of heart valve disease or congenital heart disease before treatment.
ReferencesKarchmer AW. Infectious endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 63.
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.
Fullerton DA, Harken AH. Acquired heart disease: valvular. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Sunders Elsevier;2008:chap 62.
What else can I help you with?
What is the medical term meaning backflow of blood through the mitral valve?
Mitral regurgitation is backflow of blood through the mitral valve.
What is the medical term meaning reverse flow of blood through the mitral or tricuspid valves?
Mitral regurgitation or tricuspid regurgitation is the medical term meaning backflow of blood through the mitral or tricuspid valves, respectively.
Is mitral valve regurgitation genetic?
yes
What type of regurgitation causes backflow of blood from the left ventricle into the left atrium?
Mitral regurgitation
Which valve disorder can result in left heart failure?
aortic stenosis, aortic regurgitation and mitral regurgitation
What is mitral insufficiency?
Mitral insufficiency is a disorder of the heart in which the mitral valve does not close properly. It is also called mitral regurgitation and more info can be found here: en.wikipedia.org/wiki/Mitral_regurgitationMitral
Chordae tendinae left ventricle damage?
Chordae tendinae left ventricle damage may result in severe consequences. These include Mitral valve prolapses, mitral regurgitation, bicuspid prolapse and bicuspid regurgitation.
What are some symptoms of mitral regurgitation?
There are a few symptoms of Mitral regurgitation and the severity of these symptoms can vary. The symptoms include shortness of breath, fainting, dizziness, tiredness, chest pains and the pulse of the patient being faster than normal.
What is Mitral valve regurgitation?
The mitral valve is located between the left atrium (LA) and the left ventricle (LV). In normal circulation, oxygenated blood comes from the lungs into the LA, Whe the LA contracts, the blood goes into the LV. When the LV contracts, the blood is pumped into the aorta for circulation throughout the body. The mitral valve prevents blood from going back up to the LA from the LV during ventricular contraction. Mitral regurgitation is when the mitral valve does not close properly during ventricular contraction, and allows blood to go back up to the LA.
Are heartburn, regurgitation and chronic sore throat classic symptoms of acid reflux?
Yes, heartburn, regurgitation and chronic sore throat are all indeed classic symptoms of acid reflux disease.
Can you live with mitral valve prolapse?
yes! i have it worse i have not only that but also mitral valve prolapse mitral regurgitation.
Would having a mechanical mitral valve be considered a heart condition?
Having a mechanical mitral valve is considered a condition affecting the heart, but it is not a primary heart condition. Rather, it is a treatment for a different underlying heart condition, such as mitral valve disease or regurgitation. The mechanical valve is a prosthetic device used to replace a malfunctioning or damaged natural mitral valve.
