Heart Valve Disease

Mitral Valve Regurgitation

The heart specialists at University Hospitals Harrington Heart & Vascular Institute provide advanced care for patients with mitral valve regurgitation, a type of heart valve disease. With our expertise and leading technologies, we can reduce mitral valve regurgitation symptoms and help patients avoid life-threatening complications such as atrial fibrillation, pulmonary hypertension and heart failure.

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What Is Mitral Valve Regurgitation?

Mitral valve regurgitation occurs when the leaflets or flaps of the heart’s mitral valve do not close tightly, causing blood to leak backwards through into the heart’s left atrium. As a result, blood cannot move freely and efficiently through the heart to the rest of the body, which can leave you feeling tired or out of breath.

Mitral valve regurgitation is the most common type of heart valve disease, with an estimated 4 million people in the U.S. living with the condition. Other names for mitral valve regurgitation include mitral regurgitation (MR), mitral insufficiency and mitral incompetence.

When mitral valve regurgitation is caused by mechanical problems with the mitral valve, the condition is called primary mitral valve regurgitation. When the condition is caused by another issue or disease that affects other areas of the heart, it’s referred to as secondary or functional mitral regurgitation.

Mitral Valve Regurgitation Symptoms

Mild mitral regurgitation often does not cause symptoms. When symptoms occur, they can come on suddenly or gradually. Symptoms may include:

Shortness of breath, worse when lying flat
Fatigue
Coughing
Lightheadedness
Shortness of breath, worse when lying flat, pounding or fluttering heartbeat (palpitations)
Irregular heartbeat (arrhythmia)
Increased urination at night
Swollen feet or ankles

Mitral Valve Regurgitation Causes

Mitral regurgitation is typically caused by:

Weakened heart muscles
Mitral valve prolapse
Heart valve infections
Untreated high blood pressure
Rheumatic heart disease

Diagnosis of Mitral Valve Regurgitation

To diagnose mitral valve regurgitation and other types of heart valve disease, your doctor listens to your heart with a device called a stethoscope. If they hear a whooshing sound (called a heart murmur), that may be a sign of mitral valve disease.

Tests used to diagnose mitral valve regurgitation may include:

Electrocardiogram (ECG): A quick and simple test that evaluates heart rhythm.
Transthoracic echocardiogram (TTE): This test uses high-frequency sound waves (ultrasound) to diagnose and evaluate heart disease. A TTE uses ultrasound to create pictures of the heart in motion, showing how blood moves through the heart and its valves, including the mitral valve.
Transesophageal echocardiogram (TEE): Done from inside the esophagus, a transesophageal echocardiogram (TEE) uses high-frequency sound waves (ultrasound) to diagnose and evaluate heart disease. A TEE may be ordered when more detailed imaging is needed than is possible with a standard transthoracic echocardiogram (TTE), which is done from outside the body.
Chest X-ray: A chest X-ray can show if the heart is enlarged, which can be a sign of certain types of mitral heart valve disease, including regurgitation.
Cardiac MRI: This type of imaging study uses magnetic fields and radio waves to create detailed pictures of the heart. Your doctor may order a cardiac MRI to determine the severity of your mitral valve disease.
Stress/exercise tests: In this test, you walk on a treadmill or ride a stationary bike while your heart is checked. It shows how the heart responds to physical activity and if exercise triggers valve disease symptoms.
Cardiac catheterization: In this procedure, a doctor guides a thin, flexible tube (catheter) through a blood vessel to the heart. Dye flows through the catheter, causing the heart arteries to display more clearly on an X-ray. Cardiac catheterization isn't generally used to diagnose mitral valve disease, but it can be helpful if other tests haven't diagnosed the condition when it is still suspected.

Managing Symptoms of Mitral Valve Regurgitation

Even small lifestyle changes can help you manage mitral valve regurgitation symptoms and improve your overall heart health. If you are diagnosed with this condition, our heart specialists will recommend:

Diet focused on heart-health: Too much sodium can increase stress on your heart and aggravate symptoms. We’ll help you understand how to fill your diet with more fresh fruits and vegetables and less sodium and saturated fat.
Exercise: An easy way to keep your heart healthy is to increase your activity levels. We’ll teach you how to be more active and the amount and type of exercise that is safe for your condition.
Maintain a healthy weight: Being overweight can increase your risk for conditions such as diabetes and high blood pressure and also make your heart disease symptoms worse. Our heart specialists will help you determine an ideal weight for your body type. If necessary, we’ll create a personalized weight loss plan.
Quit smoking: Smoking can lead to lung and heart damage and worsen heart disease symptoms. If you smoke, we can provide resources to help you quit.

Mitral Valve Regurgitation Treatment

Our heart and vascular specialists will take the time to design an individualized treatment plan based on your symptoms, the severity of the condition, your age and other factors. If you have mild mitral regurgitation, we may recommend medication, healthy lifestyle changes and close monitoring, including frequent echocardiograms. Valve repair or total replacement is often the best treatment option when the mitral valve regurgitation is more severe.

Medication

Medications that can help relieve mitral valve regurgitation symptoms and prevent complications, including:

Water pills (diuretics) to reduce or prevent fluid buildup in the lungs and other parts of the body.
Blood pressure medicines such as beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers.
Blood thinners (anticoagulants) to help prevent blood clots in people with atrial fibrillation.
Medications to control abnormal heartbeats.

You may be referred to a specialist if you need medication for managing heart failure (weakened heart muscles) or an abnormal heart rhythm such as atrial fibrillation.

Procedures to Treat Mitral Valve Regurgitation

If you have moderate or severe mitral valve regurgitation, you may need to have your mitral valve repaired or replaced even if you don't have symptoms, to reduce the risk of serious complications such as congestive heart failure, atrial fibrillation and stroke. A multidisciplinary valve team will determine the best treatment for your condition.

Surgical and other procedures to treat primary and secondary mitral valve regurgitation include: