Mitral Valve Regurgitation: Symptoms| Causes| Testing| Treatment

Mitral valve regurgitation is also known as mitral regurgitation, mitral insufficiency, or mitral incompetence, is a condition in which your heart’s mitral valve does not close tightly, making your blood flow backward into your heart. If mitral valve regurgitation is significant, blood may not move as efficiently from your heart or to the rest of your body, leaving you feeling tired or out of breath.

What is Mitral Valve Regurgitation?

The main and important function of the four heart valves is to direct and ease the flow of blood through the heart. The mitral valve is a one-way valve that divides the left atrium, the heart chamber that receives blood through the lungs, from the left ventricle, the heart chamber that pumps out oxygen-rich blood for the body.

When the left ventricle contracts, the mitral valve closes so that blood does not flow backward and re-enter the left atrium and later the lungs. Mitral valve regurgitation occurs when the two flaps or leaflets of the mitral valve do not close properly. Mitral valve regurgitation is, in short, an inefficient or leaky mitral valve.

The mitral valve regurgitation life expectancy is widely non-comparison able. Estimates of long-term survival in patients with mitral regurgitation – between 97-27% at five years – have been reported.

Mitral Valve Regurgitation Symptoms

Few people with mitral valve disease may not experience symptoms even after many years but mitral valve regurgitation symptoms may worsen with times. Signs and symptoms of mitral valve regurgitation, which depend on its severity and how fast the condition develops in the body, may incorporate-

  • Abnormal heart sound (heart murmur) heard through a stethoscope.
  • The feeling of Shortness of Breath.
  • Fatigue.
  • Heart palpitations – the sensation of a fast, pulsating heartbeat.
  • Swollen Feet or Ankles.
  • Coughing.
  • Chest pain frequently.

Mitral valve regurgitation is normally mild and progresses slowly in the body. You can have no symptoms for many years and are unaware that you have the condition, and it may not develop. Detecting a heart murmur, your doctor may first suspect that you have mitral valve regurgitation. Often, however, the problem develops rapidly within the body and you may experience a sudden onset of severe mitral valve regurgitation signs and symptoms.

Mitral Valve Regurgitation Causes

The usual reason behind this is that the mitral valve is damaged. This can happen either from someone’s birth or due to a heart attack, which can weaken the tissue around it. You may hear a doctor say that a valve is “prolapsed” or if it may do not close the way it should.

Other Possible causes of mitral valve regurgitation conclude-

Mitral valve prolapsed-  In this condition, the leaflets of the mitral valve prolapse and bulge back into the left atrium during the contraction of the heart. This normal heart defect can prevent the mitral valve from shutting tightly and lead to regurgitation.

Damaged tissue cords– Over time, the tissue cords that connect the flap of the mitral valve to the heart wall can stretch or tear, especially in people with mitral valve prolapse. A tear can suddenly cause leakage through the mitral valve and may require repair by heart surgery. Trauma to the chest can also break the cords.

Radiation therapy- In some cases, radiation therapy for cancer focused on the chest area can lead to mitral valve regurgitation.

Rheumatic fever– This is due to the complication of rheumatic fever untreated strep throat which can damage the mitral valve, leading to mitral valve regurgitation sooner or later in life. Rheumatic fever is now uncommon in the United States, but it is still common in other developing countries.

Endocarditis- The infection of the lining of the heart (endocarditis) can damage the mitral valve which may include the heart valves.

Congenital heart defects- Some children are born with defects in their hearts, having a damaged heart valve too.

Heart attack- The area of ​​the heart muscle that supports the mitral valve, affecting the function of the valve can be damaged because of a heart attack. If the damage is large enough, a heart attack can cause sudden and severe mitral valve regurgitation.

Certain medications— Long-term use of certain medications can cause mitral valve regurgitation, such as ergotamine (Cafergot, Migergot) which is used to treat migraines and other conditions.

Heart muscle abnormality (cardiomyopathy)– Over time, certain conditions, such as high blood pressure which may cause your heart to work harder, frequently enlarging your heart’s left ventricle. This may stretch the tissue around your mitral valve, which can lead to leakage.

Atrial fibrillation- Atrial fibrillation is a common heart rhythm problem that can cause mitral valve regurgitation.

Stroke- Experiencing trauma, such as in a car accident, can lead to mitral valve regurgitation and sometimes severe too.

Mitral Valve Regurgitation Diagnosis

Your doctor will ask you questions related to your medical history and your family history of heart disease.  He will also do a physical exam that involves listening to your heart with a stethoscope. Mitral valve regurgitation generally produces the sound of blood leaking backward through the mitral valve (heart murmur). He only then can decide what kind of tests are needed to make a diagnosis. For testing, you may be taken to a cardiologist.

Mitral Valve Regurgitation Testing

The following tests may be ordered to diagnose mitral regurgitation in a patient-

Cardiac catheterization- Cardiac catheterization purpose of this test is not often used to diagnose mitral valve regurgitation. The cardiac catheterization technique involves threading a thin tube (catheter) through a blood vessel in your arm or groin to an artery in your heart and injecting a dye through a catheter to make the artery visible on X-rays and cardiac catheterization videos too. It provides a detailed picture of your heart’s arteries and how your heart functions. It can also measure the pressure inside the heart chambers.

Cardiac catheterization Indications-

Cardiac catheterization indications can be either a diagnostic or therapeutic procedure. The procedure is done in the evaluation and treatment of the given conditions. These are all Cardiac catheterization indications-

  • Coronary artery disease
  • Measuring the hemodynamics in the right and left side of the heart
  • Evaluate the left ventricular function
  • Evaluation and treatment of cardiac arrhythmias
  • Evaluation and treatment of valvular heart disease
  • Assessment pericardial and myocardial diseases
  • Assessment of the congenital heart diseases
  • Evaluation of heart failure all

Echocardiogram- This test is mainly used to diagnose mitral valve regurgitation. In this test, sound waves directed toward your heart from a stick-like device (transducer) placed on your chest produce video images of your heart rate. This test mainly assesses the structure of your heart, the mitral valve, and the flow of blood within your heart. An echocardiogram helps your doctor take a closer look at the mitral valve and how well it is working. The doctor may also use a 3-D echocardiogram.

The doctor may do another type of echocardiogram called a transesophageal echocardiogram. In this test, a small transducer attached to the end of a tube is inserted down your esophagus, which allows getting a closer look at the mitral valve rather than on a regular echocardiogram.

Cardiac CT- A CT angiogram of the chest, abdomen, and pelvis may be done to determine if you are a candidate for robotic mitral valve repair.

Exercise tests or stress tests- Mitral valve regurgitation and exercise had a perfect relationship with each other. Various exercise tests help measure your activity tolerance and monitor your heart’s response to physical exertion. If you are unable to exercise, medications that mimic the effects of exercise on your heart may be used.

Electrocardiogram (ECG)– Wires (electrodes) attached to pads glued to your skin measure electrical impulses from your heart. An ECG can easily detect enlarged chambers of your heart, heart disease, and check the abnormal heart rhythms.

Chest X-ray- This can enable your doctor to determine whether the left atrium or left ventricle is enlarged the potential indicators of mitral valve regurgitation and the overall condition of your lungs.

Cardiac MRI- Cardiac MRI utilizes magnetic fields and radio waves to create detailed images of your heart. This test can be used to determine and check the seriousness of your condition and to assess the size and the function of your lower left heart chamber (left ventricle).

Mitral Valve Regurgitation Treatment   

If in case you have a mild mitral valve regurgitation case, you may not need any treatment. Mitral valve regurgitation treatment depends on how severe your condition is, if you are experiencing signs and symptoms and if your condition is getting worse. The main aim of treatment is to improve your heart function while minimizing your signs and symptoms and avoiding future complications.

Your doctor will still want to keep a watchful eye on you with regular checkups. Some specific treatment will be determined by your doctor-

  • Your age, overall health, and medical history
  • The extent of disease
  • Your signs and symptoms
  • Your tolerance level for specific drugs, procedures, or treatments
  • Expectations for the course of the disease
  • Your opinion or preference

Mitral Valve Regurgitation Medications

Your doctor may prescribe medication to treat the symptoms, although medication cannot cure mitral valve regurgitation.

Beta-Blockers- Beta-blockers are drugs that can help slow and monitor heart rate, prevent migraine episodes, manage glaucoma, and more.

Diuretics– These drugs can relieve fluid accumulation in your lungs or legs, which can accompany mitral valve regurgitation.

High blood pressure medications– High blood pressure worsens the mitral valve regurgitation. So in case if you have high blood pressure, your doctor may prescribe medication to help lower it.

Blood-thinning drugs– These sorts of drugs can help to prevent blood clots and may be utilized if you have atrial fibrillation.

Mitral Valve Regurgitation Surgery

Your mitral valve may need to be repaired or replaced. Your doctor may suggest mitral valve repair recovery or replacement through mitral valve regurgitation surgery even if you are not experiencing and seeing any symptoms, as this can prevent complications and improve outcomes. If you need surgery for other heart diseases too, your doctor can repair or replace the diseased mitral valve at the same time.

Often valve replacement is the best option you need just like mitral valve repair recovery or replacement but you may feel shortness of breath after mitral valve repair surgery. The typical cost for mitral valve repair was $30,720 and $28,717.

Mitral valve surgery is normally done through a cut (incision) in the chest. In few cases, doctors can perform minimally invasive heart surgery, which includes the use of smaller incisions than those utilized in open-heart surgery.

A specialist at a few medical centers may perform robot-assisted heart surgery, a kind of minimally invasive heart surgery. In this mitral valve surgery, surgeons see the heart in a magnified high-definition 3-D view on a video monitor and use the robotic arms to mimic the typical maneuvers utilized in open-heart surgery. Your doctor then only will discuss with you that whether mitral valve repair recovery or mitral valve replacement which can be the most suitable for your situation. He or she can also check whether to determine whether you are a candidate for minimally invasive heart surgery or open-heart surgery.

Doctors probably may recommend mitral valve repair recover, because it can protect your valve and can maintain heart function. However, if mitral valve repair is not possible in your situation then doctors may need to perform a mitral valve replacement.

However, after surgery, your heart valve should be long-lasting, although the valve may wear out over time. But you may feel some issues like shortness of breath after mitral valve repair surgery, Palpitationsdiscomfort in the chest, etc.

Mitral Valve Regurgitation Surgery Options Include-

1- Mitral valve repair

The Surgeons may repair the valve by reattaching the valve flaps (leaflets), replacing the cords that support the valve, or removing surplus valve tissue so that the leaflets close solidly through mitral valve repair recovery. Surgeons can often tighten or strengthen the ring around a valve (annulus) by implanting an artificial ring (annuloplasty band).

For mitral valve repair recovery, the doctor can use a long, thin tube (catheter) to repair the mitral valve in some cases. In a catheter strategy, doctors insert a catheter with a clip attached to an artery in the groin and lead it to the mitral valve.

Doctors use clips to reposition the valve. Individuals who have severe symptoms of mitral valve regurgitation and who are not contenders for mitral valve regurgitation surgery or who have a high surgical risk should be considered for this procedure. In other procedures, doctors may repair an already replaced mitral valve that is leaking by inserting a device to plug the leak.

2- Mitral valve replacement

If your mitral valve cannot be repaired, you may need to replace the mitral valve through mitral valve replacement recovery. In this mitral valve replacement recovery, your surgeon removes your damaged valve and replaces it with a mechanical valve or valve made through the cow, pig, or human heart tissue (organic tissue valve).

Biological tissue valves wear out over time, and often eventually need to be replaced. People with mechanical valves need to take blood-thinning medications throughout life to prevent blood clots. Your doctor will discuss the risks and benefits of each type of heart valve with you and tell you which valve may be suitable for you.

The Mitral replacement surgery cost was higher at $45,485 and $40,800, accordingly. Mitral valve replacement life expectancy has long-lasting benefits but patients need to take blood-thinning medications for the rest of their lives. Mitral replacement surgery is best but you may feel shortness of breath after mitral valve repair surgery.

Risk Factors of Mitral Valve Regurgitation

  • Severe regurgitation can cause blood clots, gel-like clumps that can cause serious problems if they travel to the lungs or brain.
  • This condition can also cause fluid to build up in the lungs, putting pressure on the right side of the heart.
  • If you have regurgitation, less blood is going through your body.
  • Your heart works hard to make up for the shortfall.
  • If this goes on for a long time, your heart can become enlarged, making it difficult to pump blood and increasing your risk of heart failure.
  • It can also lead to an irregular or uneven, heartbeat or stroke in your body.

Mitral Valve Regurgitation and Exercise

Mitral Valve Regurgitation and Exercise are correlated with each other. If you have mild to moderate mitral valve regurgitation (MR) and don’t have symptoms, you probably don’t need to limit your physical activity.

You may need to be vigilant about physical activity if you have symptoms or if you have an irregular heart rhythm or changes in the size or function of your heart. But regular activity, like a low level of activity like walking, can help to keep your heart healthy. If you want to start being more active, talk to your doctor first. Your doctor can help you create a safe mitral valve regurgitation exercise plan.

If in case you may have questions or concerns about what physical activities are suitable for you, talk with your doctor about that. Even with MR, you may be able to develop a mitral valve regurgitation exercise plan that fits your lifestyle.

If you have severe MR, you may need to limit your physical activity-

  • If you have mild to moderate regurgitation and normal heart function, you can participate in normal physical activity.
  • In case you have mild to moderate regurgitation and reduced heart function, talk to your doctor about what level and kind of activity are safe and suitable for you. You can be able to exercise at low or moderate aerobic levels, such as walking or swimming to keep your heart fit.

In some cases, you may need to avoid isometric exercises, which are exercises that use muscle contractions to strengthen and tone your muscles. This is because isometric exercises usually have to push against resistance, as in weightlifting. This type of exercise can raise your blood pressure, which can increase the force against which your heart must pump blood. As a rule, avoid activities that involve sudden physical exertion that significantly exceeds the level required for your normal activities.

Lifestyle Changes for Mitral Valve Regurgitation

Keeping your blood pressure under control- Controlling your high blood pressure is necessary if you have mitral valve regurgitation.

Eating a heart-healthy diet- Food does not directly affect mitral valve regurgitation. But a healthy diet can seriously help to prevent other heart diseases in your body which can weaken the heart muscle. You should eat foods that are low in saturated and trans fats, sugar, salt, and refined grains, such as white bread. Start eating a variety of vegetables and fruits, whole grains, and proteins, such as lean meats, fish, and nuts in your meal.

Seeing your doctor regularly- Create a regular evaluation program with your cardiologist or primary care provider. Discuss with your doctor if you notice any change in your signs or symptoms

Maintaining a healthy weight– Keep your weight with the range suggested by your doctor.

Prevention of infective endocarditis- If your heart valves have been replaced, your doctor may recommend that you take antibiotics before dental procedures to prevent an infection called infective endocarditis. Consult with your doctor to check out whether he recommends that you take antibiotics before dental procedures.

Pregnancy- If you are a woman with mitral valve regurgitation, it is very necessary to urgently talk to your doctor before becoming pregnant. Because pregnancy causes the heart to work harder. How a heart with mitral valve regurgitation handles this extra workload depends on the level of regurgitation and how well your heart pumps. During your pregnancy and after delivery, your cardiologist and obstetrician should monitor you

Control alcohol consumption- Heavy alcohol consumption can cause arrhythmias and make your symptoms worse. Excessive alcohol consumption can also lead to cardiomyopathy, a condition of the weak heart muscle that leads to mitral regurgitation.

Abstaining from tobacco- You need to quit smoking for a healthy heart.

Doing regular physical activity- How long and hard you can exercise depends on your condition’s severity and how intense your exercise level is.  You need to consult with your doctor for guidance before starting to exercise, especially if you’re considering competitive sports.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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