Heart Disease: Information on Mitral Valve Regurgitation

Mitral valve regurgitation is a condition in which the valve on the left side of your heart does not close properly and allows blood to leak backward into the heart. It is sometimes referred to simply as mitral regurgitation or mitral insufficiency. If left untreated, mitral valve regurgitation can lead to congestive heart failure. It is estimated that one in five people over the age of 55 have mitral valve regurgitation to some degree.

It is very possible to never experience symptoms of mitral valve regurgitation. When symptoms do occur, they often develop over a long period of time. If symptoms do develop, they can include shortness of breath, extreme tiredness, a buildup of fluid in the legs and feet called edema, cough, and excessive urination at night. There are a number of causes for mitral valve regurgitation. Some of the most common are infections such as rheumatic fever and endocarditis, deterioration of the mitral valve due to age, mitral valve prolapse, or prior heart attack. Also, some infants are born with defects in their heart, including a mitral valve that leaks.

Mitral valve regurgitation is a serious condition, and your health care provider should be called if symptoms are present. Since symptoms often do not appear for some time, mitral valve regurgitation typically comes to your doctor's attention during a routine physical exam when your doctor hears a murmur (an abnormal heart sound) when listening with a stethoscope. To achieve a proper diagnosis, other tests are often performed. These may include a chest x-ray, echocardiogram, electrocardiogram (EKG), Holter monitor, MRI scans, cardiac catheterization, and/or transesophageal electrocardiogram (TEE).

When mild, mitral valve regurgitation may be left untreated. However, more serious cases can lead to serious complications such as congestive heart failure, atrial fibrillation, stroke, blood clots, endocarditis (infection of the heart valve), or arrhythmias.

Treatment depends on the symptoms present and the severity of your condition. Some people with mild mitral valve regurgitation need only close observation with regular checkups by their doctor. A variety of medications are also used in treatment. Antibiotics can be prescribed before dental work or surgery to reduce the risk of infections such as endocarditis. Anticoagulants such as warfarin or Coumadin may be used to prevent blood clots. Antihypertensive drugs can also be used to help improve the condition since increased blood pressure puts additional strain on the heart. In severe cases, surgery may ultimately be required to repair or replace your mitral valve. The prognosis after surgery is generally very good.

To help maximize your quality of life after being diagnosed with mitral valve prolapse, your doctor may suggest measures such as checking your blood pressure regularly; eating a low-fat, low-sodium diet; maintaining a healthy weight; cutting back on caffeine; avoiding alcohol; regular exercise; and seeing your cardiologist or primary care provider routinely for maintenance screening.