Mitral regurgitation

Specialty of Paediatric cardiothoracic surgery

What is mitral valve regurgitation?

Mitral regurgitation is the most common heart valve disorder and occurs when the heart valve does not close properly meaning that there is a backflow of blood from the left ventricle to the left atrium. The leakage of blood backward through the mitral valve occurs every time that the left ventricle contracts.

What are the symptoms of mitral regurgitation?

For some people, there are no signs of mitral regurgitation or the symptoms develop gradually over time and may even take years to appear. These may include:

  • fatigue
  • abnormal heart murmur, which is heard through a stethoscope
  • dizziness
  • heart palpitations, such as fast heart rate sensations
  • difficulty breathing, especially after physical activity or when lying down
  • swollen feet or ankles

In some cases, the symptoms appear suddenly due to a heart attack or a rupture of the valve cords.
 

What are the causes of mitral valve regurgitation?

The heart has four valves – the mitral, tricuspid, pulmonary and aortic valves - that keep the blood flowing in the right direction. Each of the valves has flaps that open and close during each heartbeat. Sometimes the valves do not open or close properly, which disrupts the blood flow through the heart to the body. With a mitral valve regurgitation, the valve between the left chamber and the lower left chamber does not close fully, which causes blood to leak backwards into the left atrium. It is caused by problems that occur in the mitral valve, which are known as primary mitral valve regurgitation. Possible causes are:
 

  • coronary heart disease
  • arterial hypertension
  • displacement of the mitral valve
  • heart attack
  • rare diseases such as Marfan syndrome (a genetic disorder of the connective tissue)
  • rheumatic heart disease
  • swelling of the heart
     

How is mitral regurgitation prevented?

Implementing lifestyle changes such as eating healthily (fruits, vegetables, wholegrain and organic meat and fish) can help overall wellbeing. High blood pressure can make mitral regurgitation worse, so blood pressure lowering medicines may help. Limiting salt intake is recommended for those who have hypertension. The reduction of caffeine and alcohol lowers the risk of arrhythmias.
 

What is the treatment for mitral regurgitation?

There may be regular examinations and monitoring of mitral valve regurgitation but treatment depends on the severity of the individual case. If it is mild or moderate, then medical treatment may not be needed but the doctor will watch the condition regularly.

In more severe cases, mitral regurgitation surgery is required to repair the mitral valve. Sometimes a patient may need a replacement valve, which is made of pig, cow or human heart tissue. There are also man-made mechanical valves as an option.

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