Mitral Valve Regurgitation – Symptoms and Causes
Overview
Mitral valve regurgitation is the most widespread heart valve problem. The condition occurs when the valve connecting the left chambers of the heart fails to close properly. This allows blood to flow backward instead of moving forward as it should.
When this leakage becomes severe, it reduces the amount of blood circulating through the heart and reaching other body parts. People with this condition often experience extreme fatigue and breathing difficulties.
This condition goes by several names:
- Mitral regurgitation (MR)
- Mitral insufficiency
- Mitral incompetence
For mild cases, treatment might not be necessary. However, regular health checkups are important to monitor the condition. Some patients may need medication to manage symptoms.
Severe cases typically require more aggressive intervention. Doctors might recommend a catheter procedure or heart surgery to either repair or replace the damaged valve. Without proper medical attention, severe mitral valve regurgitation can lead to serious complications including:
- Heart rhythm abnormalities
- Heart failure
The mitral valve sits between the left atrium (upper chamber) and left ventricle (lower chamber). When functioning correctly, this valve ensures blood flows in the proper direction.
A leaky mitral valve allows blood to flow backward into the left atrium when it should be moving forward into the body’s circulation. This backward flow makes the heart work harder and less efficiently.
Signs and Symptoms
Mitral valve regurgitation often develops gradually with mild effects. Many people may not experience symptoms for years. However, when this condition occurs suddenly, it is known as acute mitral valve regurgitation.
The most common symptom people experience is fatigue, though this can be caused by many conditions. Other symptoms include:
- Irregular heartbeat (arrhythmia)
- Difficulty breathing, particularly when lying down
- Palpitations (feeling a rapid, fluttering, or pounding heartbeat)
- Swelling in the feet or ankles
When Medical Attention Is Needed
If you notice any symptoms related to mitral valve regurgitation, schedule a health checkup right away. Your primary care provider may refer you to a cardiologist, a doctor who specializes in heart conditions, for further evaluation and treatment.
What Causes Mitral Valve Regurgitation
Mitral valve regurgitation happens when the mitral valve in the heart doesn’t close properly. This allows blood to flow backward, making the heart work harder than it should. There are several factors that can lead to this condition.
Primary vs. Secondary Regurgitation
- Primary Regurgitation: Occurs due to problems with the valve itself.
- Secondary Regurgitation: Happens when other heart problems affect the valve.
Common Causes
One of the most frequent causes is mitral valve prolapse. This happens when the valve flaps bulge backward into the upper heart chamber during heartbeats. The bulging prevents the valve from closing completely, allowing blood to leak backward.
Heart attacks can damage the heart muscle that supports the mitral valve. Significant damage can lead to sudden and severe regurgitation, sometimes called ischemic mitral regurgitation.
People born with congenital heart defects may have structural problems with their heart valves from birth. These abnormalities can prevent proper valve function.
Damaged tissue cords that connect valve flaps to the heart wall can cause leakage. These cords may stretch or tear over time, especially in people who already have mitral valve prolapse. Chest injuries can also rupture these important cords.
Disease-Related Causes
Rheumatic fever, a rare complication of untreated strep throat, can damage the mitral valve. This damage might cause regurgitation immediately or years later. This specific type is called rheumatic mitral valve disease.
Cardiomyopathy (thickening of heart muscle) makes it harder for the heart to pump effectively. Both dilated and hypertrophic forms of cardiomyopathy can affect how the mitral valve works.
Endocarditis is an inflammation of the heart’s inner lining, including the valves. It’s typically caused by infection when bacteria enter the bloodstream and attach to already damaged areas of the heart.
Other Factors
In rare cases, radiation therapy directed at the chest area for cancer treatment can lead to mitral valve damage and regurgitation.
Risk Factors
Several factors can raise your chance of developing mitral valve regurgitation:
- Heart infections that damage valve tissue
- Heart attacks that affect valve function
- Birth defects of the heart
- Other valve problems like mitral valve prolapse
- Advanced age
- Chest radiation from cancer treatment
These risk factors may weaken or damage the mitral valve, causing blood to flow backward into the heart’s upper chamber.
Complications
Mitral valve regurgitation can lead to various health problems, especially when it becomes severe. People with mild cases typically don’t experience significant issues.
When the condition worsens, the heart works harder to move blood throughout the body. This extra strain can cause the left ventricle to enlarge and the heart muscle to weaken over time.
Several serious complications can develop from severe mitral valve regurgitation:
- Atrial Fibrillation: This irregular and often fast heart rhythm commonly occurs with mitral valve regurgitation. When present, it increases a person’s risk for:
- Blood clots
- Stroke
- Pulmonary Hypertension: High blood pressure can develop in the lung blood vessels when mitral regurgitation remains untreated or inadequately managed. This increased pressure leads to fluid buildup in the lungs.
- Heart Failure: The heart must work harder with severe mitral valve regurgitation. This extra effort causes the left ventricle to enlarge. Without treatment, the heart muscle weakens and can no longer pump blood effectively throughout the body.
Regular medical check-ups are important for people with mitral valve regurgitation. Early detection and proper management of the condition help prevent these complications.
