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What is mitral valve regurgitation?

Valvular heart disease occurs when the heart's valves that control blood flow do not work properly. Valvular conditions can be present at birth or can be acquired later in life, resulting in valvular regurgitation (also known as valve insufficiency). When severe, the condition can lead to heart failure and abnormal heart rhythms. Regurgitation also can affect the heart's mitral, aortic, pulmonary or tricuspid valves.

Mild cases of mitral valve regurgitation often can be managed with medications and monitored with an echocardiogram to detect how the heart is pumping. For severe mitral valve regurgitation, valve repair or replacement may be recommended.

Symptoms

When symptoms occur, they usually develop gradually, and may include:

  • Cough
  • Fatigue, exhaustion and lightheadedness
  • Rapid breathing or shortness of breath that increases with activity and when lying down
  • Palpitations
  • Excessive urination at night

Symptoms may begin suddenly if:

  • A heart attack damages the muscles around the mitral valve
  • The cords that attach the muscle to the valve break
  • An infection destroys part of the valve

Causes

Mitral valve insufficiency occurs when the valve does not close properly, causing blood flow to leak backward into the heart. Mitral valve prolapse sometimes allows leakage of blood through the valve opening, causing mitral regurgitation. The heart's ability to pump the necessary amount of blood to the rest of the body is affected.

Mitral regurgitation may begin suddenly after a heart attack.

Risk factors

You are at risk for mitral valve regurgitation if you have:

  • Coronary heart disease and high blood pressure
  • Infection of the heart valves
  • Mitral valve prolapse (MVP)
  • A rare condition such as Marfan syndrome
  • Rheumatic heart disease
  • Swelling of the left lower heart chamber (ventricle)

Diagnosis

As a follow-up to a stethoscope exam, these tests may be done to look closely at the heart valve structure and function:

  • CT chest scan
  • Echocardiogram (transthoracic or transesophageal)
  • Magnetic resonance imaging (MRI)
  • Cardiac catheterization, if heart function becomes worse

Treatments

Very often, medication is used to treat valvular disease, especially for people with high blood pressure or a weakened heart muscle. If you are not displaying symptoms, your doctor may recommend evaluation to manage the disease. However, surgical procedures, minimally invasive or traditional, may be required.

Prevention

If you have heart valve disease or a congenital heart disease, tell your healthcare provider and dentist before treatment; sometimes antibiotics may be necessary before dental procedures or surgery.

A low sodium diet also may be helpful.

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