What is Mitral Valve Regurgitation?
Mitral valve regurgitation is the most prevalent form of heart valve disease. In this condition, the mitral valve—located between the heart’s left atrium and left ventricle—fails to close completely, allowing blood to flow backward into the left atrium during contraction. This leakage can compromise the heart’s ability to pump sufficient blood to the body, often resulting in symptoms such as fatigue and shortness of breath. Other names for this condition include mitral regurgitation (MR), mitral insufficiency, and mitral incompetence.
Symptoms of MVR
Mitral valve regurgitation may progress gradually, often remaining asymptomatic for years. However, when the condition worsens rapidly, it is termed acute mitral valve regurgitation. Symptoms can include:
- Fatigue: A common but nonspecific symptom.
- Shortness of breath: Especially when lying down.
- Palpitations: Sensations of rapid, pounding, or fluttering heartbeat.
- Swelling: Notably in the feet or ankles.
Causes of MVR
To understand the causes of mitral valve regurgitation, it’s essential to know how the heart functions. The heart contains four valves that maintain unidirectional blood flow. The mitral valve’s flaps (leaflets) are crucial for preventing backflow. If these flaps do not close tightly, blood leaks backward, complicating the heart’s operation.
Mitral valve regurgitation can be categorized into two types:
Primary Mitral Valve Regurgitation
Direct issues with the mitral valve, such as:
- Mitral Valve Prolapse: A common condition where the valve’s flaps bulge into the left atrium, preventing proper closure.
- Rheumatic Fever: A complication of untreated strep throat that can damage heart valves.
- Congenital Heart Defects: Structural heart issues present at birth.
Functional or Secondary Mitral Regurgitation
Conditions affecting other heart areas can lead to valve leakage, such as:
- Heart Attacks: Damage to heart muscles can impact valve function.
- Cardiomyopathy: Thickening of the heart muscle complicates blood pumping.
- Endocarditis: Inflammation of the heart lining, often due to infections.
Risk Factors
Certain factors may elevate the risk of developing mitral valve regurgitation, including:
- Previous heart infections
- History of heart attacks
- Congenital heart defects
- Existing heart valve diseases
- Advancing age
- Radiation therapy to the chest
Complications
The severity of mitral valve regurgitation can lead to various complications:
- Atrial Fibrillation: An irregular heartbeat that increases the risk of stroke.
- Pulmonary Hypertension: Elevated blood pressure in the lungs, leading to fluid accumulation.
- Congestive Heart Failure: The heart’s inability to pump adequately due to excessive strain.
Diagnosis
Diagnosis of mitral valve regurgitation begins with a comprehensive physical examination, including listening to the heart with a stethoscope to detect characteristic murmurs indicative of backward blood flow.
Tests
Common diagnostic tests include:
- Echocardiogram: A key imaging technique that uses sound waves to visualize heart structures and assess blood flow.
- Electrocardiogram (ECG): Monitors heart rhythm and can reveal irregularities associated with mitral valve issues.
- Chest X-ray: Evaluates heart size and lung condition.
- Cardiac MRI: Offers detailed images of heart structures.
- Cardiac Catheterization: Occasionally employed for further assessment if other tests are inconclusive.
Staging
After diagnosis, healthcare professionals may stage the disease based on symptoms and severity:
- Stage A: At risk of heart valve disease.
- Stage B: Mild to moderate valve disease without symptoms.
- Stage C: Severe valve disease without symptoms.
- Stage D: Severe valve disease causing symptoms.
Outlook
The prognosis for individuals with mitral valve regurgitation varies significantly and depends on:
- The underlying cause of the disease
- The stage and severity of the regurgitation
- The duration of the condition
Treatment Options
The treatment strategy aims to enhance heart function, alleviate symptoms, and prevent complications. Options may include:
- Monitoring: Individuals with mild regurgitation may require regular checkups without immediate intervention.
- Lifestyle Changes: Encouraging heart-healthy habits.
- Surgical Intervention: Severe cases often necessitate surgical repair or replacement of the mitral valve.
Surgical Procedures
- Mitral Valve Repair: The preferred approach when feasible. It involves repairing the existing valve to restore proper function.
- Mitral Valve Replacement: Involves substituting the diseased valve with either a mechanical or biological valve.