Mitral Valve Regurgitation

Mitral valve regurgitation is a heart valve disorder characterized by the backflow of blood from the left ventricle to the left atrium due to the incomplete closure of the mitral valve.

 

Types

  • Acute mitral regurgitation: This type develops suddenly and is usually caused by damage to the mitral valve due to conditions such as infective endocarditis, rupture of the chordae tendineae (fibrous cords that support the mitral valve), or papillary muscle dysfunction.
  • Chronic mitral regurgitation: This type develops gradually over time and is often associated with mitral valve prolapse, rheumatic heart disease, degenerative valve disease, or ischemic heart disease.

 

Causes

Mitral valve regurgitation can be caused by various factors, including:

  • Mitral valve prolapse: The valve leaflets bulge back into the left atrium during contraction.
  • Rheumatic heart disease: Scarring and deformity of the mitral valve due to a prior episode of rheumatic fever.
  • Degenerative valve disease: Age-related wear and tear or degeneration of the mitral valve.
  • Infective endocarditis: Infection of the heart valves, leading to damage or destruction of the mitral valve.
  • Ischemic heart disease: Reduced blood flow to the heart muscles, causing damage to the mitral valve or its supporting structures.
  • Congenital heart defects: Abnormal development of the mitral valve present at birth.
  • Connective tissue disorders: Certain inherited disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, can affect the mitral valve.
  • Papillary muscle dysfunction or rupture: Damage or dysfunction of the muscles that support the mitral valve.

 

Symptoms

In the early stages, mitral valve regurgitation may not cause noticeable symptoms. However, as the condition progresses, common symptoms can include:

  • Fatigue and weakness
  • Shortness of breath, especially during physical activity or when lying flat (orthopnea)
  • Rapid or irregular heartbeat (palpitations)
  • Swelling in the ankles, feet, or abdomen (edema)
  • Cough, especially at night or when lying flat
  • Dizziness or fainting

 

Risk Factors

Several factors can increase the risk of developing mitral valve regurgitation, including:

  • Mitral valve prolapse
  • Rheumatic heart disease
  • Age (risk increases with advancing age)
  • Family history of mitral valve disease
  • Prior heart attack or coronary artery disease
  • Connective tissue disorders
  • History of infective endocarditis
  • Certain medications or drug use (e.g., fen-phen, certain chemotherapy drugs)

 

Diagnosis

To diagnose mitral valve regurgitation, a healthcare professional may perform various tests and assessments, including:

  • Physical examination: Listening to the heart with a stethoscope to detect abnormal heart sounds (murmurs) associated with mitral regurgitation.
  • Echocardiogram: Uses sound waves to create images of the heart and assess the structure and function of the mitral valve.
  • Electrocardiogram (ECG): Records the electrical activity of the heart to detect rhythm abnormalities.
  • Cardiac catheterization: Invasive procedure to measure pressures in the heart and assess blood flow.
  • Stress tests and imaging tests: Evaluate heart function during physical activity or under stress.

 

Treatment

The treatment of mitral valve regurgitation depends on the severity of the condition, the presence of symptoms, and the overall health of the patient. Treatment options may include:

  • Medications: To manage symptoms, control blood pressure, and prevent complications.
  • Mitral valve repair: Surgical procedure to restore the normal function of the mitral valve while preserving the natural valve tissue.
  • Mitral valve replacement: Surgical procedure to remove the damaged mitral valve and replace it with a mechanical or biological valve.
  • Transcatheter mitral valve repair: Minimally invasive procedure to repair the mitral valve using a catheter-based approach.
  • Regular monitoring: For mild cases of mitral regurgitation, regular monitoring and follow-up with a healthcare professional may be recommended to assess the progression of the condition.

When to Consult a Physician

It is important to consult a physician if you experience symptoms suggestive of mitral valve regurgitation, such as fatigue, shortness of breath, palpitations, or swelling in the extremities. Additionally, if you have a known heart condition or risk factors for mitral regurgitation and experience worsening symptoms or new symptoms, seeking medical attention promptly is crucial. A UTHealth Houston physician can evaluate your symptoms, perform appropriate tests, and provide personalized advice and treatment options.