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Mitral Regurgitation


What is mitral regurgitation?

Mitral regurgitation is also called mitral insufficiency. When your heart contracts, blood leaks backward into your left atrium. Normally, blood flows through the mitral valve from the left atrium to the left ventricle. Then the mitral valve closes. When your heart contracts, blood flows from the left ventricle out to your body.

Heart Chambers

What increases my risk for mitral regurgitation?

Mitral regurgitation is caused by damage or weakness of the mitral valve. Any of the following may increase your risk for these problems:

  • Older age
  • Being born with heart problems
  • Rheumatic fever or infection of the mitral valve
  • Heart attack, high blood pressure, or mitral valve prolapse
  • Injury to the mitral valve from trauma, a heart procedure, or radiation
  • A connective tissue disease such as lupus or Marfan syndrome
  • Certain medicines, such as weight loss pills or medicines that treat migraines

What are the signs and symptoms of mitral regurgitation?

You may not have symptoms, or you may have symptoms that develop gradually:

  • Shortness of breath that gets worse during activity or when you lie on your back
  • Chest pain or discomfort
  • A fast heartbeat or feeling your heartbeat flutter
  • Weakness, dizziness, or fatigue
  • Cough, especially when you lie down
  • Swollen feet or ankles

How is mitral regurgitation diagnosed?

Your healthcare provider will examine you and listen to your heart. You may need any of the following:

  • An echocardiogram is a type of ultrasound. It is used to show problems with your mitral valve and how blood flows through your heart. It may also show how well your heart is pumping. You may need a transthoracic or transesophageal echocardiogram. Ask your healthcare provider about these types of echocardiogram.
  • X-ray, CT, or MRI pictures may show problems with your valve or an enlarged heart. These tests may also show fluid in your lungs. You may be given contrast liquid to help your heart and lungs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • An EKG test records the electrical activity of your heart. It is used to check for an abnormal heart rhythm caused by mitral regurgitation.
  • A stress test helps healthcare providers see how well your mitral valve works under stress. Healthcare providers may place stress on your mitral valve with exercise or medicine.
  • A cardiac catheterization is a procedure to check how well your heart is pumping blood. It is also used to measure pressure in different parts of your heart. Ask your healthcare provider for more information.

How is mitral regurgitation treated?

Treatment may not be needed if your condition does not cause symptoms. Medicine may be given to treat your symptoms. You may need medicines to lower your blood pressure, or to decrease the fluid in your body. Your mitral valve may be replaced if it causes severe symptoms. It is a surgery to remove your mitral valve. A new valve is then secured in place. The new valve may be from a donor (another person or animal), or may be an artificial valve. There are 2 different approaches for valve replacement. It may be done as a open heart procedure. Your valve may also be replaced through a catheter placed through a vessel in your groin area. Your healthcare provider will talk to you about which approach is right for you.

How can I manage my symptoms?

  • Maintain a healthy weight. Being overweight can increase your risk for high blood pressure, diabetes, and coronary artery disease. These conditions can make your symptoms worse. Ask your healthcare provider how much you should weigh. Ask him or her to help you create a weight loss plan if you are overweight.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Limit the amount of alcohol you drink. Ask your cardiologist if it is safe for you to drink alcohol. Alcohol can make your heart muscle weak and make your symptoms worse.
  • Eat heart-healthy foods and limit sodium (salt). Eat more fresh fruits and vegetables. Eat fewer canned and processed foods. Replace butter and margarine with heart-healthy oils such as olive oil and canola oil. Other heart-healthy foods include walnuts, whole-grain breads, low-fat dairy products, beans, and lean meats. Fatty fish such as salmon and tuna are also heart healthy. Ask how much salt you can eat each day. Too much salt can cause fluid to build up in your body. This can increase stress on your heart.
  • Exercise as directed. Exercise can help keep your heart healthy. Ask your healthcare provider what activities are safe for you to do. The amount and type of exercise that is safe may depend on how severe your condition is.
  • Talk to your healthcare provider about pregnancy. If you are a woman and want to get pregnant, talk to your healthcare provider. Pregnancy makes your heart work harder. You and your baby may need to be monitored by specialists during your pregnancy.
  • Ask your healthcare provider if you should take antibiotics before certain procedures. Some procedures may allow bacteria to get into your blood and travel to your heart. This can make your condition worse.

Call 911 or have someone else call if:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • and any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss

When should I seek immediate care?

  • You have chest pain when you move around. It goes away when you are still.
  • You have increasing shortness of breath.
  • You faint.

When should I contact my healthcare provider?

  • The veins in your neck look swollen or are bulging.
  • You have increased swelling in your legs or ankles.
  • Your heart beats faster than usual.
  • You feel your heart flutter often.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright IBM Corporation 2018 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

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