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Mitral Regurgitation


What is mitral regurgitation?

Mitral regurgitation is when blood flows backward through the mitral valve because it does not close properly. The mitral valve is between the left ventricle and left atrium of your heart. The lower left ventricle pumps blood into your upper left atrium. The valve opens and closes to direct blood flow through your heart.

What causes mitral regurgitation?

  • Mitral valve prolapse: This is weakness of the mitral valve that develops over time. The valve does not close as tightly as it should.
  • Damage to tissue cords: These help open and close the mitral valve.
  • Rheumatic fever: This is fever and inflammation of your joints. It can develop after you have a strep throat infection. Rheumatic fever can cause scarring of your mitral valve. The valve may not work properly. This can lead to regurgitation.
  • Bacterial endocarditis: This is an infection of the lining of the heart. The mitral valve may also be infected.
  • Age: The mitral valve can get weaker and wear out as you age.
  • Medical conditions: Coronary artery disease or a heart attack can damage the muscle that controls the valve. Long-term high blood pressure causes your heart to work harder. This can cause your left ventricle to stretch and enlarge, causing the mitral valve to leak. You may have a myxoma. This is a growth on the mitral valve that causes it to not work properly.
  • Congenital heart defect: Some people are born with a damaged mitral valve.
  • Medicines: Certain medicines, such as diet pills, can cause mitral regurgitation.

What are the signs and symptoms of mitral regurgitation?

  • Severe tiredness
  • Shortness of breath during activity or when you lie down
  • Dizziness
  • Cough, especially when you lie down
  • Fast, jumpy, or fluttery heartbeat
  • Swollen feet or ankles

How is mitral regurgitation diagnosed?

Your healthcare provider will ask about your signs and symptoms and listen to your heart. You may need any of the following tests:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  • Chest x-ray: This is used to check the size of your heart and look for fluid around your heart and lungs.
  • EKG: This test records the electrical activity of your heart. It is used to check for abnormal heart rhythm caused by mitral regurgitation.
  • Transesophageal echocardiogram: This test is also called a TEE. It will show regurgitation, enlarged heart, or an infection. You will be given medicine to relax you during a TEE. Healthcare providers will put a tube in your mouth that is moved down into your esophagus. The tube has a small ultrasound sensor on the end. Since your esophagus is right next to your heart, your healthcare provider can see your heart clearly.
  • Cardiac catheterization: This procedure is done to find and treat regurgitation. A thin, bendable tube is inserted into your arm, neck, or groin and moved into your heart. An x-ray may be used to guide the tube to the right place. Dye may be put into your vein so the pictures show up better on a monitor. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

How is mitral regurgitation treated?

  • Medicines:
    • Diuretics: This medicine is given to remove extra fluid that has collected in your heart, lungs, or legs. They are often called water pills. You may urinate more often when you take this medicine.
    • Blood pressure medicine: This will help lower your blood pressure and keep your heart from working too hard.
  • Procedures:
    • Repair: Healthcare providers make an incision in your chest to repair your mitral valve. This helps improve the blood flow through your heart.
    • Replacement: Healthcare providers make an incision in your chest to replace your damaged mitral valve. Part or all of your mitral valve is removed and a new valve is secured in place. You may get a new valve from a donor (another person or animal), or you may get an artificial valve. When you have an artificial valve, you may need to take antibiotic medicine when you have medical procedures. This includes before and after dental work or surgery. The antibiotic medicine will help prevent germs from causing an infection in your heart.

What are the risks of mitral regurgitation?

  • Your heart may not be able to pump enough blood to your body. Your heart can swell and weaken. Blood and fluid may build up in your lungs, and your heart or lungs may begin to fail. Mitral regurgitation may cause abnormal heartbeats, which can cause blood clots in your heart. A blood clot may travel to your brain and cause a stroke.
  • You may get an infection in your heart. If you are pregnant, mitral regurgitation may cause health problems for you and your unborn baby. These problems can be life-threatening. Without treatment, your symptoms may get worse.

How can I manage my symptoms?

  • Eat a variety of healthy foods: Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. You may need to limit the amount of salt you eat. Ask if you need to be on a special diet.
  • Exercise: This will improve your heart health. Ask your healthcare provider about the best exercise plan for you.
  • Maintain a healthy weight: Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.

When should I contact my healthcare provider?

  • You have a fever or are more tired than usual.
  • You are short of breath when you exercise or lie down.
  • You cough more than usual, especially when you lie down.
  • You are dizzy.
  • Your ankles and feet are swollen.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • Your heart is beating faster than normal for you, and you feel fluttering in your chest.
  • You have chest pain that feels like squeezing, pressure, or fullness.
  • You have chest pain that lasts for more than a few minutes or returns.
  • You are nauseated and have trouble breathing.
  • You have a severe headache, a cold sweat, and feel lightheaded or dizzy.
  • You have weakness or numbness in one arm or leg, or on one side of your face.
  • You are confused and cannot speak clearly.

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 caregivers 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.

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