What is mitral valve regurgitation?
Heart valves work like one-way gates, helping blood flow in one direction between heart chambers or in and out of the heart. The mitral valve is on the left side of your heart. It lets blood flow from the upper to the lower heart chamber.
See a picture of mitral valve regurgitation .
When the mitral valve is damaged-for example, by an infection-it may no longer close tightly. This lets blood leak backward, or regurgitate, into the upper chamber. Your heart has to work harder to pump this extra blood.
Small leaks are usually not a problem. But more severe cases weaken the heart over time and can lead to heart failure.
What causes mitral valve regurgitation?
There are two forms of mitral valve regurgitation: chronic and acute.
Chronic mitral valve regurgitation, the most common type, develops slowly.
- Primary regurgitation means there is a problem with the anatomy of the valve. The valve does not work well and does not close tightly. This might happen because of problems like calcium buildup on the valve. It can also happen in people who have mitral valve prolapse.
- Secondary regurgitation means another heart problem causes the valve to not close tightly. The anatomy of the valve is typically normal. The heart problem, such as heart failure, affects the heart muscle, and this causes regurgitation.
- Acute mitral valve regurgitation develops quickly and can be life-threatening. It happens when the valve or nearby tissue ruptures suddenly. Instead of a slow leak, blood builds up quickly in the left side of the heart. Your heart doesn't have time to adjust to this sudden buildup of blood the way it does with the slow buildup of blood in chronic regurgitation. Common causes of acute regurgitation are heart attack and a heart infection called endocarditis.
What are the symptoms?
Symptoms of mitral valve regurgitation include being tired or short of breath when you are active.
If your heart weakens because of your mitral valve, you may start to have symptoms of heart failure. Call your doctor if you start to have symptoms or if your symptoms change. Symptoms include:
- Shortness of breath with activity, which later develops into shortness of breath at rest and at night.
- Extreme tiredness and weakness.
- A buildup of fluid in the legs and feet, called edema.
How is mitral valve regurgitation diagnosed?
Because you may not have symptoms, a specific type of heart murmur may be the first sign your doctor notices. Further tests will be needed to check your heart. Tests may include:
- Echocardiograms, which use ultrasound to see how serious the valve problem is.
- An electrocardiogram (EKG, ECG) to look for abnormal heart rhythms.
- A chest X-ray to check heart size.
- Cardiac catheterization to see how serious the problem is.
Finding out that something is wrong with your heart is scary. You may feel depressed and worried. This is a common reaction. Sometimes it helps to talk to others who have similar problems. Ask your doctor about support groups in your area.
How is it treated?
Treatment for chronic cases includes regular tests to check how well the valve and the heart are working. You may take medicines to treat complications. You may take medicine to treat a heart problem that is causing the regurgitation.
You may need surgery to repair or replace your mitral valve. Your doctor will check many things to see if surgery 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.
If you have chronic mitral valve regurgitation, your doctor may want you to make some lifestyle changes to help keep your heart healthy. He or she may advise you to:
- Quit smoking and stay away from secondhand smoke.
- Follow a heart-healthy diet and limit sodium.
- Be active. Ask your doctor what level and type of exercise is safe for you. You may need to avoid intense activity.
- Stay at a healthy weight, or lose weight if you need to.
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.