Mitral valve regurgitation is a condition where one of the heart’s valves, called the mitral valve, does not close properly. Normally, heart valves open and close with each heartbeat to make sure that blood flows in only one direction. In mitral valve regurgitation, when the valve does not close fully, it causes blood to flow or “leak” backward into the heart’s upper chamber. This makes the heart work harder to push blood out to the rest of the body. This condition is also known as mitral valve insufficiency or mitral valve incompetence.
Mitral valve regurgitation can happen suddenly (acute), or gradually over time (chronic). There are two types:
Like other heart valve diseases, mitral valve regurgitation may not cause symptoms at first. As the condition becomes more severe, it will start to affect the heart’s function and symptoms may appear. The first symptom is often shortness of breath (feeling like you cannot get enough air into your lungs). Other symptoms include:
The causes of mitral valve regurgitation vary based on type:
You are also at higher risk if you have had chest radiation, a common treatment for different cancers.
Your cardiologist will listen to your heart and lungs with a stethoscope, looking for a “clicking” sound made by the valve leaflets. They may also hear a murmur from the blood leaking backward. These sounds are often the first signs of mitral valve regurgitation.
Also known as an ECG or EKG, this test records the electrical signals in the heart to check its rhythm. Valve problems make the heart work harder and can cause heart rhythm issues. This test is often performed in your cardiologist’s office.
A transesophageal echocardiogram (TEE) is a type of echocardiogram that uses a thin tube placed down your throat into the esophagus to take detailed video of your heart function, especially the mitral valve from inside your body. It is one of the best ways to confirm mitral valve regurgitation, diagnose its severity and identify the cause of mitral regurgitation. TEEs are performed at the following BayCare locations:
This procedure shows how the mitral valve opens and closes, measuring blood flow and pressure on both sides of the mitral valve. Your cardiologist may also check for coronary artery disease using coronary angiography. This is an imaging process that evaluates the heart’s blood vessels. The following BayCare hospitals perform diagnostic cardiac catheterizations:
This test takes 3D X-ray images to measure the mitral valve’s structure. These measurements can help your cardiologist understand if your mitral valve has stretched, thickened, or calcified. This test can be scheduled at a BayCare Imaging Center.
Treatment for mitral regurgitation depends on several factors including suddenness of symptoms, severity, and your overall health. Mild or moderate cases may only need treatment if the condition worsens or is causing symptoms. Your cardiologist may watch your condition and order testing over time. When it becomes severe, common treatments include:
Your cardiologist may recommend some lifestyle adjustments to improve symptoms including:
Medications can reduce symptoms but cannot correct the underlying structural problem with the mitral valve. Common medications your cardiologist may prescribe include:
This traditional “open chest” surgery is used to repair or replace the mitral valve. The chest is opened at the breastbone, and a heart-lung machine is used to take over the work of the heart and lungs during surgery. If the valve is replaced, a cardiovascular or cardiothoracic surgeon may use mechanical (metal)or bioprosthetic valve. BayCare has three award-winning open-heart surgery programs at these hospitals:
Transcatheter Mitral Valve Repair (TMVr) is a minimally invasive option for people who cannot have open-heart surgery. Unlike traditional surgery, TMVr does not require opening the chest or temporarily stopping the heart. During TMVr, a catheter is inserted through a vein in the leg and is used to implant a clip on the mitral valve. This clip helps the valve leaflets come together and improve their ability to open and close. This procedure is sometimes referred to as transcatheter edge-edge repair (TEER). TMVr is available at these BayCare Hospitals:
Transcatheter Mitral Valve Replacement (TMVR) is another minimally invasive procedure. A special catheter is inserted through a blood vessel and is used to place a new mechanical or bioprosthetic valve inside the existing mitral valve. It does not require opening the chest or a heart-lung machine. TMVR is performed at the following BayCare Hospitals:
People with mitral valve regurgitation can live a full life if the condition is effectively managed. Since it is a progressive condition, most people will eventually need treatment. After treatment, your cardiologist or surgeon may prescribe cardiac rehab to help your heart recover. Here are some tips for living with mitral valve regurgitation:
Dr. Joshua Rovin discusses causes, symptoms and diagnosis of mitral valve regurgitation as well as the preventative measures at treatment options available.
