About Us    Contact Us    Careers    Site Map    Search

Health Care Services    Hospitals & Facilities    Health Information    Find a Doctor    Why Choose Baptist
 
Home Health Information Health Topic Library Cardiovascular Health
Mitral Valve Regurgitation
 
What is mitral valve regurgitation?
The mitral valve lies on the left side of the heart between the left upper chamber (atrium) and lower chamber (ventricle). The valve has 2 flaps called leaflets that normally close every time the ventricle squeezes to pump blood out of the heart. When the mitral valve doesn't close properly, some of the blood from the ventricle is forced back up (regurgitated) into the left atrium instead of flowing out to the rest of the body. The added workload on the heart and the increased blood pressure in the lungs may eventually cause problems.

How does it occur?
Rheumatic fever can damage valve leaflets and cause scarring. The scars can deform the leaflets so that they don't close properly. A condition called mitral valve prolapse can also cause mitral regurgitation. In mitral valve prolapse one or both of the leaflets bulge (prolapse) into the upper left chamber (atrium) of the heart. A small amount of mitral regurgitation (MR) is common with mitral valve prolapse.

If one or more of the cordlike structures attaching the leaflets to the heart muscle breaks, the valve may leak. Heart attacks, diseases of the heart muscle, or other heart valve abnormalities may cause the whole heart to enlarge. The enlargement stretches the mitral valve ring and muscular attachments, pulling the valve leaflets apart. When the leaflets no longer meet, leaking of the mitral valve (mitral regurgitation) results.

Over time, the added workload on the heart may cause heart failure. Heart failure occurs when the heart can't pump enough blood to keep the lungs or other body tissues from filling with fluid.

Mitral regurgitation may cause both the left ventricle and left atrium to get larger. If the left atrium becomes big enough, an irregular heart rhythm called atrial fibrillation may result.

What are the symptoms?
People with mild to moderate MR may have no symptoms. Over time, the added workload on the heart may cause shortness of breath with exercise or an abnormal rhythm. This abnormal rhythm feels like your heart is pounding, racing, or skipping in your chest.

If a valve leaflet cord breaks, the sudden MR may quickly cause heart failure. The main symptoms of heart failure are:

  • tiredness
  • shortness of breath or trouble breathing, at first during exercise and later with any activity or even when you are resting
  • waking up at night with trouble breathing or having a hard time lying flat in bed because of shortness of breath
  • swollen ankles and feet and weight gain due to too much fluid in the body
  • loss of appetite.

How is it diagnosed?
Most MR causes a heart murmur that can be heard through a stethoscope and easily recognized. Enlargement of the heart may be discovered during a physical examination.

The echocardiogram uses ultrasound waves to make pictures of the heart. The pictures show the size of the heart chambers, the thickness of the heart muscle, and the movement of the heart valves. Doppler echo is a special kind of ultrasound that shows the backflow of blood through a valve. The echocardiogram can measure the amount of MR.

How is it treated?
If you have MR with a normal-sized heart and no symptoms, you need no treatment except for antibiotics before having dental work or procedures that involve the rectum, bladder, or vagina. The antibiotics prevent infections from starting on the mitral valve. Moderate to severe MR eventually results in heart enlargement and symptoms. Most people with symptoms will need valve repair or replacement. If you delay treatment for too long, your heart muscle may already be seriously damaged.

Surgery is often needed. If the valve is not too badly deformed, it may be possible for the surgeon to repair it instead of replacing it. Surgeons repair the existing valve by narrowing the valve ring and tailoring the valve leaflets. A plastic support ring is stitched around the valve to bring the leaflets closer together. An advantage of this kind of surgery is that long-term use of blood-thinning drugs is not needed.

Sometimes the mitral valve leaflets are damaged so badly that they must be replaced. Artificial heart valves made of human or pig tissue work well but may not last as long as man-made valves. They don't require long-term blood thinners after surgery. Artificial mechanical valves also work very well. These valves last longer without wearing out, but blood thinners must be taken for life.

Other than surgery, drugs that expand (dilate) blood vessels and slightly lower blood pressure are the only medicines known to be helpful in treating MR. They work best for those who are very ill, because they help them feel better. Though the drugs work well at first, they don't seem to be the answer for the long term.

How can I take care of myself?
  • Check with your health care provider if your symptoms worsen.
  • Tell your dentist and other health care providers that you have mitral valve regurgitation so you can make sure that you take antibiotics when you need them to prevent infection of the valve.
  • Talk to your provider before you use any other medicines, including nonprescription medicines.
  • If you smoke, stop.
  • Get regular checkups
  • Lose weight if you are overweight.
  • Learn ways to reduce or manage stress.
  • Avoid taking aspirin if you're taking an anticoagulant (blood-thinning drug).
  • Limit the salt in your diet if recommended by your provider.
  • Ask your provider about a potassium supplement if you're taking diuretics that could cause potassium loss.
  • If you have high blood pressure, make sure you follow your health care provider's treatment plan for it.
  • If you have significant mitral regurgitation, you should probably avoid heavy exercise.
  • Tell all other health care providers you see that you have mitral valve stenosis.




Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File CRD3638F.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.


Top of Page

Baptist Online
Read the latest articles about a variety of health subjects, with many practical tips to help you take control of your health.
More

See Information Related to This Topic
Home | Health Care Services | Hospitals & Facilities | Health Information | Find a Doctor | Why Choose Baptist
©2009 Baptist Memorial Health Care Corporation. All Rights Reserved. Disclaimer. Notice of Privacy Practices.
Baptist Memorial Hospital In keeping with the three-fold ministry of Christ — healing, preaching and teaching — Baptist Memorial Health Care Corporation is committed to providing quality health care.