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Mitral Valve Regurgitation

Overview

The mitral valve lets blood flow from the upper to lower areas of the heart. Mitral valve regurgitation occurs when the valve can't close all the way and blood backs up into the upper area of the heart. This causes the heart to work harder to pump the extra blood.

You may have this condition for many years without having problems. But over time, it can weaken the heart and lead to heart failure.

This condition can be caused by many things, including calcium buildup on the valve and other health problems such as coronary artery disease or rheumatoid arthritis.

Your doctor may just want to watch your health closely if you have mild mitral valve regurgitation. You may take medicine to treat a problem that is causing the regurgitation. Or you may take medicine for other health problems that are caused by this condition. You may need surgery to repair or replace the valve.

  • Symptoms

    Mitral valve regurgitation

    Location of mitral valve in the heart and detail of mitral valve regurgitation

    Mitral valve regurgitation happens when the mitral valve does not close tightly enough after blood flows through the valve into the lower chamber of the heart. This makes a small opening in the valve even when the valve is closed. This opening can let blood leak (regurgitate) back into the upper chamber of the heart.

    What are the symptoms of mitral valve regurgitation?

    Symptoms of chronic mitral valve regurgitation may take decades to appear. They include being tired or short of breath when you are active.

    Because you may not have symptoms, a specific type of heart murmur might be the first symptom your doctor notices.

    If your heart weakens because of your mitral valve, you may start to have signs of heart failure. They include:

    • Shortness of breath with activity. This can later develop into shortness of breath at rest and at night.
    • Extreme tiredness and weakness.
    • A buildup of fluid in the legs and feet. This buildup is called edema.

    Acute mitral valve regurgitation is an emergency. Symptoms come on quickly. They include severe shortness of breath, fast heart rate, lightheadedness, weakness, confusion, and chest pain.

  • Causes

    What causes mitral valve regurgitation?

    The cause of mitral valve regurgitation depends on the type. It may happen because of problems like calcium buildup on the mitral valve. Heart failure, a heart attack, or a heart infection may also cause this to happen. This condition can also happen in people who have mitral valve prolapse.

  • Diagnosis

    How is mitral valve regurgitation diagnosed?

    When your doctor suspects that you have mitral valve regurgitation, he or she will ask about your past health and do a physical exam.

    Your doctor may also order tests to check your heart. Tests may include:

    • An echocardiogram. This uses ultrasound to see how serious the valve problem is.
    • An electrocardiogram (EKG, ECG). This looks for abnormal heart rhythms.
    • A chest X-ray to check heart size.
    • An MRI test to see how well the heart is pumping blood and to check how severe the problem is.
    • Cardiac catheterization to see how serious the problem is.

    Acute mitral valve regurgitation causes sudden symptoms and is much less common.

  • Treatment

    How is mitral valve regurgitation treated?

    Treatment for chronic mitral valve regurgitation includes regular tests to check how well the valve and the heart are working. You may take medicine to treat problems caused by the regurgitation. Or you may take medicine to treat a heart problem that's causing it.

    You may need to have your mitral valve repaired or replaced. Your doctor will check many things to see if repair or replacement is right for you. These things include the cause of the regurgitation, the anatomy of the valve, if you have symptoms, and how well your heart is pumping blood.

    Treatment for acute mitral valve regurgitation occurs while you are in the hospital or the emergency room. You need surgery right away to repair or replace the valve.

  • When to Call

    Mitral valve regurgitation: When to call

    Call 911 anytime you think you may need emergency care. For example, call if:

    • You have severe trouble breathing.
    • You cough up pink, foamy mucus.
    • You have symptoms of a heart attack. These may include:
      • Chest pain or pressure, or a strange feeling in the chest.
      • Sweating.
      • Shortness of breath.
      • Nausea or vomiting.
      • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
      • Lightheadedness or sudden weakness.
      • A fast or irregular heartbeat.
      After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

    Call your doctor now or seek immediate medical care if:

    • You have new or increased shortness of breath.
    • You are dizzy or lightheaded, or you feel like you may faint.
    • You have sudden weight gain, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
    • You have increased swelling in your legs, ankles, or feet.
    • You are suddenly so tired or weak that you cannot do your usual activities.

    Watch closely for changes in your health, and be sure to contact your doctor if you develop new symptoms.

  • Self-Care

    Caring for yourself when you have mitral valve regurgitation

    You can live life more fully by doing things that help keep your heart and body healthy. Here's how.

    • Make healthy lifestyle changes.
      • If you smoke, try to quit. Medicines and counseling can help you quit for good. Avoid secondhand smoke too.
      • Your doctor will also recommend that you follow a heart-healthy diet and limit how much sodium you eat.
      • Be active, but ask your doctor what level of exercise is safe for you. You may need to be careful with physical activity if you have symptoms, irregular heart rhythms, or changes in your heart size or function. But regular activity, even low-level activity like walking, will help keep your heart healthy. If you want to start being more active, talk to your doctor first. Your doctor will help you create a safe exercise plan.
      • If you need to lose weight, try to reach and stay at a healthy weight.
    • Take care of yourself.
      • See your doctor right away if you have new symptoms or symptoms that get worse.
      • Go to your checkup appointments. And get the tests you need to assess your heart, such as echocardiograms.
      • Manage other health problems, such as high blood pressure, diabetes, and high cholesterol.
      • Practice good dental hygiene, and have regular checkups. Good dental health is especially important. That's because bacteria can spread from teeth and gums to the heart valves.
      • Get a flu vaccine every year. And get a pneumococcal vaccine shot. If you've had one before, ask your doctor if you need another dose.
      • Talk with your doctor if you have concerns about sex and your heart. He or she can help you know if or when it's okay for you to have sex.

    Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.