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Mitral Valve Regurgitation

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The heart disorder in which the mitral valve fails to close tightly when the heart pumps out the blood is called as mitral valve regurgitation, mitral incompetence or mitral insufficiency (MI). The blood from the left ventricle leaks through the mitral valve into the left atrium, on contraction of the left ventricle. This backflow is called as regurgitation. The condition is one of the most common forms of valvular heart disease.

What is Mitral Valve?

The mitral valve is the leaflet or tissue flaps that lies between the left ventricle and left atrium. There are two flaps or cusps of the mitral valve. These flaps do not turn inside out due to the presence of thin strands called chordae, that fix the flaps inside the walls of the ventricle. In case the chordae are damaged or scarred, it may compromise their functioning ability. Thus, preventing the mitral valve from working normally, leading to mitral valve regurgitation or mitral valve stenosis.

Under normal conditions, the valve mitral helps the blood flow from the left atrium into the left ventricle on contraction of the left atrium. When the left ventricle contracts, the blood flows through the aortic valve into the aorta. When the mitral valve is damaged, it allows backflow of blood from the left ventricle into the left atrium on contraction.

What are the Symptoms of Mitral Valve Regurgitation?

Signs of mitral valve regurgitation depend on the severity and the rate of progress of the condition.In case of acute mitral regurgitation, the patient will show symptoms of:

  • Shortness of breath
  • Pulmonary edema
  • Orthopnea
  • Paroxysmal nocturnal dyspnea
  • Low exercise tolerance
  • Palpitations
  • Swelling of legs and feet (edema)
  • Cardiogenic shock

In case of chronic compensated mitral valve regurgitation, the condition may appear to be asymptomatic. They will show tolerance to normal exercise levels and have no signs of heart failure. However, they are more prone to congestive heart failure.

Mitral valve regurgitation is a slow developing condition. The patient may not show any symptoms for many years. It is often detected with the help of a heart murmur heard with the help of a stethoscope.

What are the Causes of Mitral Valve Regurgitation?

There are two types of mitral valve regurgitation, primary and secondary. In case of primary regurgitation, there is an abnormality in the mitral valve and in the secondary, the abnormality lies in the left ventricle. Some of the causes of mitral insufficiency include:

  • Mitral valve prolapse, that is, the abnormal closure of the valve where the tip of the cusps folds backwards causing a leak.
  • Rheumatic fever or bacterial endocarditis that causes scarring of the heart tissue
  • Damage to the heart after a heart attack
  • Congenital heart defects that lead to compromised mitral valve function.
  • Cardiomyopathies that weaken the muscles and the mitral valve.
  • Medications such as ergotamine, etc. can damage the heart muscles.

Diagnosis of Mitral Valve Regurgitation

During a routine check up, the doctor a pick up a heart murmur that indicates regurgitation. In case of acute mitral regurgitation, the condition often leads a patient to the hospital emergency room.

When diagnosing chronic mitral valve regurgitation, the doctor will take a complete medical history of the patient, in order to understand the severity of the condition. The doctor will note the details of the symptoms experienced, take blood pressure, check pulse, observe the veins in the neck, check the legs and feet for swelling, etc.

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Diagnostic tests that help confirm mitral valve regurgitation include echocardiogram, electrocardiogram, chest x-ray, transesophageal echocardiogram and cardiac catherization.

How is Mitral Valve Regurgitation Treated?

Treatment formitral valve regurgitation depends on the severity of the condition. Mild regurgitation does not require any treatment. The patient is kept under a watch and regularly called for check-up to observe the progress of the condition. Medications can’t reverse the condition, but will be helpful in relieving any fluid accumulated in the lungs or legs. Blood clots, if any, can be treated with the help of anticoagulants. Low-salt diet and blood pressure medications ill help control high blood pressure.

Surgery is required even when the patient remains asymptomatic. These surgeries include valve repair surgery called annulopasty or a valve replacement surgery. The new valves placed in the heart can either be mechanical valves made of durable metal or tissue valves from cow, pig or deceased human donor.

Patients with mitral valve regurgitation will have to undergo certain lifestyle changes. These include eating a low-salt diet, avoiding caffeine, maintain healthy body weight, abstinence or control on alcohol intake, regular exercising and regular checkups with their doctor. For further details, speak to your cardiologists for more clarification.

Written by: healthplus24.com team

Date last updated: January 20, 2015