What is Mitral Valve Regurgitation?

Mitral valve regurgitation is a condition in which the flaps, or leaflets, of the mitral valve don’t close tightly. This allows some of the blood being pumped from the left atrium to the left ventricle to flow backward, or regurgitate into the left atrium.

Baptist Health is known for advanced, superior care for patients with heart problems and the diagnosis, management and treatment of mitral valve regurgitation. The Valve Team at Baptist Health Louisville is dedicated to offering the full range of therapeutic options to patients. Our minimally invasive valve surgeries and interventional procedures have outstanding clinical outcomes and patient satisfaction.

You will appreciate timely appointments and respectful attention to your concerns, all in a positive and friendly atmosphere. Here, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Mitral Valve Regurgitation Signs and Symptoms

Minor mitral valve regurgitation often does not cause any symptoms. In more severe mitral valve regurgitation, symptoms may include:

• Fatigue, especially during increased activity
• Heart murmur – an irregular sound heard when blood flows turbulently through the heart
• Heart palpitations – rapid or fluttering heartbeats
• Shortness of breath with exertion or when lying flat
• Swollen feet or ankles

Mitral Valve Regurgitation Diagnosis

To determine if a patient has mitral valve regurgitation, the physician will ask questions about family history and symptoms and listen to the patient’s heart with a stethoscope. We use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Cardiac catheterization: During this test, a long, thin flexible tube is threaded through a blood vessel in the arm or groin and to the heart. Contrast material is injected through the tube and a type of X-ray movie is taken to show how the aortic valve functions and measure pressure in the heart chambers.

Cardiac MRI: In this test, a large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

Chest X-ray: This is a common imaging test of the heart and aorta, which can identify enlargement of the left atrium or ventricle.

CT angiogram: During this test, a thin tube (catheter) is inserted into a blood vessel and dye injected to make the blood vessel visible during an X-ray. This can show blood vessel abnormalities.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves. It can identify abnormalities in the structure or function of the mitral valve.

Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged or overworked. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.

Mitral Valve Regurgitation Causes

Mitral valve regurgitation causes include factors that can lead to heart disease, such as:

• High blood pressure
• High cholesterol
• Obesity
• Physical inactivity
• Smoking

Risk Factors

Risk factors that could contribute to mitral valve regurgitation include:

Mitral valve prolapse: In this condition, the leaflets and tendon-like cords supporting the mitral valve weaken and stretch so that when the left ventricle contracts, the valve leaflets bulge into the left atrium. This common defect can prevent the mitral valve from closing and lead to regurgitation.

Age: Some mitral valve regurgitation is evident in most people by middle age. 

Other heart conditions: Certain conditions like cardiomyopathy and a previous heart attack can damage the mitral valve and affect its function.

Certain medications: Prolonged use of certain medications, like some used to treat migraines and other conditions, can cause mitral valve regurgitation.

Congenital heart defects: Some people are born with damaged heart valves.

Infections: Certain infections including endocarditis and rheumatic fever can raise the risk of mitral valves regurgitation.

Previous heart attack: A heart attack can damage the mitral valve and affect its function.

Prevention

While many risk factors cannot be controlled, you can help prevent cases of mitral valve regurgitation caused by heart disease. 

Get enough exercise: Even moderate activity can make a big difference in heart health and help you maintain a healthy weight.

Stop smoking: Smoking can lead to high blood pressure and otherwise damage the heart. 

Take medications as prescribed: If you’re on medications to lower cholesterol or blood pressure, continue taking them as directed.

Watch what you eat: Stick to a diet rich in fruit, vegetables and whole grains and low in fat, sugar and salt.

Mitral Valve Regurgitation Prognosis

Prognosis for mitral valve regurgitation varies based on its severity, whether it be major or mild mitral valve regurgitation. Medication can ease symptoms, but cannot reverse mitral valve regurgitation. Surgical treatments have greatly improved the prognosis for mitral valve regurgitation patients.

Mitral Valve Regurgitation Treatment and Recovery

Treatment for mitral valve regurgitation depends on the severity of the condition. If you are diagnosed with mitral valve regurgitation but have few or no symptoms, your doctor may recommend lifestyle changes and regular monitoring by a physician. Other treatments can include:

Medication

Medication can’t correct valve damage or defects, but some can help the symptoms. Depending on your symptoms and the severity of your condition, your doctor may prescribe medications to lower blood pressure, remove excess fluid from the body or prevent blood clots.

Surgery

• Mitral valve replacement or repair can often be done using minimally invasive techniques. In some cases, more extensive surgery is required. Surgical treatment can include:
• Mitral valve repair: A surgeon repairs the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. He or she may also tighten or reinforce the ring around the valve.
• Mitral valve replacement: If your mitral valve can't be repaired, your surgeon may replace it with a mechanical or biological valve. Mechanical valves are made from metal while biological valves are made of human or animal tissue.

Depending on the type of surgery you have, recovery after valve surgery can take a long time. Your activities will be limited, you will experience some physical and emotional changes during recuperation, and you may have problems such as chest pain or trouble sleeping.

Complications

Mild mitral valve regurgitation may not cause problems, but a severe case can lead to complications like:

Atrial fibrillation: This heart rhythm irregularity, in which the upper chambers of the heart beat chaotically and rapidly, can cause blood clots, which can break loose from your heart and travel to other parts of your body. This can lead to a stroke if it cuts off blood supply to the brain.

Heart failure: This occurs when the heart can't pump enough blood to meet the body's needs.

Pulmonary hypertension: This type of high blood pressure affects the vessels in the lungs, leading to shortness of breath, dizziness, fainting, leg swelling and other symptoms.