What is Mitral Valve Regurgitation?
Mitral valve regurgitation, also called mitral regurgitation or mitral insufficiency, is the incorrect flow of blood due to incomplete closure of the mitral valve within the heart. Thus, when the left ventricle (lower chamber of the heart) contracts, the blood flows in two directions, from the left ventricle into the aorta and back into the left atrium (upper heart chamber) instead of flowing unidirectionally.
Anatomy of the Heart
Your heart is located slightly to the left of your breastbone, in the center of your chest, between your lungs. It is enclosed by a double-layered membrane called the pericardium which acts as a shock absorber providing protection to your heart. The inside of your heart is hollow and four-chambered and is divided into the atria: the two top chambers, which receive blood from your veins, and the ventricles: the two bottom chambers, which pump blood into your arteries.
There are four heart valves within your heart: aortic valve, mitral valve, tricuspid valve, and pulmonary valve. These valves prevent the blood from flowing in the wrong direction.
Causes of Mitral Valve Regurgitation
Mitral valve regurgitation may be caused due to the following reasons:
- Congenital heart defects: Being born with malformed heart valves
- Prolapsed mitral valve: Mitral valve flaps bulge backwards into the left atrium during the heart's contraction
- Heart disorders including endocarditis, infection of the endocardium (inner lining of the heart), cardiomyopathy, abnormal expansion of the heart muscles and atrial fibrillation, abnormal heart rhythm
- Heart attack
- Rheumatic fever
- Trauma due to a vehicular accident
- Certain drugs
- Radiation therapy focused on the chest region
Signs and Symptoms of Mitral Valve Regurgitation
Some people with mitral valve disease may not experience any symptoms as mitral valve regurgitation progresses slowly.
Upon progression, the common signs and symptoms may include:
- Dyspnea (shortness of breath), especially when you lie down or upon exertion
- Heart palpitations
- Fatigue
- Swollen ankles or feet
- Abnormal heart sounds (murmur) heard through a stethoscope
Diagnosis of Mitral Valve Regurgitation
Your doctor will note your present symptoms, medical history and your family history of heart disease. You will undergo a thorough physical exam that includes listening to your heartbeat using a stethoscope.
Your doctor may also order diagnostic tests like a chest X-ray, cardiac MRI, echocardiogram, electrocardiogram (ECG), exercise or stress tests, cardiac computed tomography (CT) scan or cardiac catheterization to confirm mitral valve regurgitation.
Treatment Options for Mitral Valve Regurgitation
Treatment depends on the severity of mitral valve regurgitation. The different approaches to treat mitral valve regurgitation include:
Medications
Your doctor may prescribe:
- Blood pressure medications to control your high blood pressure
- Blood thinners to prevent blood clots and provide symptomatic relief from atrial fibrillation
- Diuretics to reduce fluid accumulation in your legs or lungs
Surgery
You may be recommended surgery if medications don’t improve your condition. Mitral valve regurgitation can be treated either through repair or replacement of the mitral valve.
Surgical Procedure
Mitral valve surgery can be performed through any of these approaches:
- Open-heart surgery that involves making a relatively large incision in your chest
- Minimally invasive heart surgery that involves making one or two smaller incisions in your chest using specialized instruments
- Robot-assisted heart surgery, a type of minimally invasive surgery where your surgeon views a magnified high-definition 3-D view of your heart on a screen and uses robotic arms to duplicate specific movements used in open-heart surgeries
These treatments aim to treat your signs and symptoms, improve your heart's function and avoid future complications.
Lifestyle Modifications
Your doctor may suggest the following lifestyle changes:
- Consume a healthy diet low in trans and saturated fats, salt and sugar. Avoid refined grains like white bread. Include fruits, vegetables, nuts, and whole grains.
- Keep your blood pressure under control.
- Maintain a healthy weight.
- Reduce alcohol intake and refrain from smoking.
- Perform regular physical activities.
- Visit your doctor regularly.
For a woman with mitral valve regurgitation, it's important to visit your doctor before planning for a baby and during your pregnancy as pregnancy puts an extra load on your heart and makes it work harder.
