mitral valve regurgitation (MR) can be difficult to
diagnose. It is a "quiet" condition and often has no symptoms, or your symptoms
may be confused with other heart-related conditions.
Chronic MR is
often diagnosed during a routine checkup or a visit to the doctor for another
heart murmur may be the first sign leading your doctor
to the diagnosis, especially if you have no other symptoms.
It’s dramatic when someone has a heart attack on television or in the movies. But in real life, symptoms can be more subtle and difficult to identify. And because heart attack and angina symptoms are so similar, it may be hard to tell what's going on.
But knowing the differences -- and the reasons behind them -- can result in seeking treatment sooner, and living longer.
MR causes sudden symptoms and is much less common than chronic mitral valve
regurgitation. It is usually diagnosed while you are already hospitalized or in
the emergency room.
When your doctor suspects you have MR, he or
she will discuss your medical history, do a physical exam, and likely
order tests to find out the
severity of the regurgitation.
Medical history and physical exam
find out the severity of your MR, your doctor will ask you to describe the
symptoms you are experiencing, such as shortness of breath, fatigue, or chest
If you have chronic MR, you will see your doctor at least once a year for a physical exam. If you have severe MR, you may see your doctor more often. Call your doctor if you start to have symptoms for the first time or if your symptoms get worse.
During the physical exam, the doctor will take your blood
pressure, check your pulse, listen to your heart and lungs, look at the veins
in your neck (jugular veins), and check your legs and feet for fluid buildup
After the medical history and physical exam, your
doctor may order a variety of tests, such as an echocardiogram or chest X-ray.
Your doctor will want to know:
The size of your
left ventricle as your heart finishes contracting (end
systolic dimension, or ESD). In chronic MR, the left ventricle expands as it
tries to accommodate the larger amount of blood that flows back into the
chamber. The larger the left ventricle, the more advanced the MR. This applies
only to the chronic form of the disease because the left ventricle does not
expand in acute MR. MR may also develop in response to dilation of the left
ventricle that occurs for some other reason.
ejection fraction. This shows the efficiency of your
heart. Ejection fraction is the amount (percentage) of blood pumped out of the
ventricle compared to the total amount of blood in the left ventricle at rest.
The smaller the ejection fraction, the harder your heart must work to pump a
sufficient volume of blood.
Echocardiogram (sometimes called an echo or
echocardiography) is a type of
ultrasound exam. It is the best noninvasive
method of finding out the severity of MR. Also, echocardiography can help
determine whether the heart's main pumping chamber (left ventricle) is
functioning properly, whether any structural problems exist that may affect the
mitral valve, and whether the chambers of the heart are enlarged.