The flow of blood pumped by the heart is controlled by one-way valves. These valves assure that blood moves in only one direction. Mitral regurgitation occurs when the heart's mitral valve leaks blood into the upper chamber from the lower chamber.
If the amount of blood that leaks is severe, mitral regurgitation can be serious. The sooner it is treated, the better the outcome.
Mitral Valve Regurgitation
Mitral regurgitation may be caused by:
- Mitral valve prolapse—Abnormal closure of the valve with protrusion of a leaflet tip backward into the left atrium, causing it to leak.
- Infections that cause scarring of the heart valve, such as rheumatic fever or bacterial endocarditis.
- Damage from a heart attack.
- Several different types of congenital heart defects , which can affect mitral valve function.
- Cardiomyopathies—Diseases that weaken the heart muscle and stretch the mitral valve.
Factors that may increase your chance of developing mitral regurgitation include:
- A history of rheumatic fever or other serious infectious disease
- Autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis
- Storage diseases such as hemochromatosis and glycogen storage disease
- Cardiovascular disease
- Muscle disease
- Radiation exposure
- Exposure to certain drugs such as lithium, sulfonamides, cancer chemotherapy, and phenothiazines
The speed with which symptoms progress closely follow the cause of mitral disease. Acute diseases cause rapid decline, while more chronic diseases lead to slower onset of symptoms.
Mitral regurgitation may cause:
- Chronic, progressive fatigue
- Shortness of breath, especially with exertion
- Worsening shortness of breath when you lie down
- New, associated palpitations or racing heart rate, which may suggest the development of a heart arrhythmia
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Leaking heart valves usually make sounds called murmurs that can be heard through a stethoscope. You will likely be referred to a cardiologist.
Imaging tests evaluate the heart and surrounding structures. These can be done with:
An electrocardiogram (EKG) can measure your heart's electrical activity.
Treatment options depend on the severity and history of the valve leakage and its effects on the heart’s size and function. Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Treat Underlying Disease
Correcting the underlying problem may help the mitral valve function. The treatment depends on the symptoms. In chronic and slowly progressive mitral regurgitation, medications may help reverse effects on the heart’s size. Ultimately, surgery will likely be needed. In acute and rapidly declining disease, the benefit of medications is limited to short term stabilization until emergency surgery occurs.
To help reduce your chance of getting mitral regurgitation:
- Prevent cardiovascular disease by controlling weight and blood pressure, exercising, eating heart-healthy foods, and watching your cholesterol levels
- Avoid contact with streptococcal diseases including strep throat, pharyngitis, and scarlet fever
- Get prompt treatment for infections
- Avoid IV drug use
- Limit alcohol intake
American Heart Association
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
Braunwald E. Valvular heart disease. In: Isselbacher K, et al. (Eds). Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill; 1998.
Mitral regurgitation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 2, 2014. Accessed August 20, 2014.
Shipton B and Wahba H. Valvular heart disease: review and update. Am Fam Physician. 2001;63:2201-2208.
Wood AJJ. Adverse reactions to drugs. In: Isselbacher K, et al. (Eds.) Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill; 1998.
Wynne J, Braunwald E. The cardiomyopathies and myocarditides. In: Isselbacher K, et al. (Eds). Harrison's Principles of Internal Medicinem. 14th ed. New York: McGraw-Hill; 1998.
Last reviewed August 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.