Overview

Mitral valve regurgitation is a type of heart valve disease in which the valve between the left heart chambers doesn't close completely, allowing blood to leak backward across the valve. It is the most common type of heart valve disease (valvular heart disease). If the leakage is severe, not enough blood will move through the heart or to the rest of the body. As a result, mitral valve regurgitation can make you feel very tired (fatigued) or short of breath.

Other names for mitral valve regurgitation are:

  • Mitral regurgitation (MR)
  • Mitral insufficiency
  • Mitral incompetence

Treatment of mitral valve regurgitation may include regular monitoring, medications or surgery. Some people with mitral regurgitation don't need treatment, especially when the regurgitation is mild.

Severe mitral valve regurgitation often requires a catheter procedure or heart surgery to repair or replace the mitral valve. Without proper treatment, severe mitral valve regurgitation can cause heart rhythm problems (arrhythmias) or heart failure.

Video: Mitral valve regurgitation

The mitral valve is located between the upper left heart chamber (left atrium) and the lower left heart chamber (left ventricle). A healthy mitral valve keeps your blood moving in the right direction. A leaky valve doesn't close the way it should, allowing some blood to flow backward into the left atrium. If left untreated, a leaky valve could lead to heart failure.

Symptoms

Mitral valve regurgitation is often mild and progresses slowly. Some people with mitral valve regurgitation might not have symptoms for many years.

But sometimes, mitral valve regurgitation develops quickly. This condition, called acute mitral valve regurgitation, causes sudden signs and symptoms.

Fatigue is a common but nonspecific symptom of mitral valve regurgitation. Other signs and symptoms of mitral valve regurgitation include:

  • Sound of blood flow across the valve (heart murmur)
  • Irregular heartbeat (arrhythmia)
  • Shortness of breath (dyspnea), especially when lying down
  • Sensation of a rapid, pounding or fluttering heartbeat (palpitations)
  • Swollen feet or ankles (edema)

When to see a doctor

If you develop symptoms that suggest mitral valve regurgitation or another problem with your heart, see your health care provider right away.

If you have a heart murmur, you may be referred to a doctor that specializes in heart diseases (cardiologist).

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Causes

To understand the causes of mitral valve disease, it may be helpful to know how the heart works.

The mitral valve is one of four valves in the heart that keep blood flowing in the right direction. Each valve has flaps (leaflets) that open and close once during each heartbeat. If a valve doesn't open or close properly, blood flow through the heart to the body can be reduced.

In mitral valve regurgitation, the valve flaps don't close tightly. Blood leaks backward when the valve is closed, making it harder for the heart to work properly.

If mitral valve regurgitation is due to problems with the mitral valve, the condition is called primary mitral valve regurgitation.

If a problem or disease affecting other areas of the heart cause a leaky mitral valve, the condition is called functional or secondary mitral regurgitation.

Possible causes of mitral valve regurgitation include:

  • Mitral valve prolapse. In this condition, the mitral valve's flaps bulge back into the left upper heart chamber (atrium) when the heart squeezes (contracts). This common heart problem can prevent the mitral valve from closing tightly and cause blood to flow backward.
  • Rheumatic fever. Rheumatic fever is a complication of untreated strep throat. Rheumatic fever can damage the mitral valve, leading to mitral valve regurgitation early or later in life. If rheumatic fever causes mitral valve disease, the condition is called rheumatic mitral valve disease. Rheumatic fever is rare in the United States.
  • Heart attack. A heart attack can damage the area of the heart muscle that supports the mitral valve. If heart attack damage is very extensive, the event can cause sudden and severe mitral valve regurgitation. A leaky mitral valve caused by a heart attack is called ischemic mitral regurgitation.
  • Heart problem present at birth (congenital heart defect). Some people are born with heart structure problems, including damaged heart valves.
  • Thickening of the heart muscle (cardiomyopathy). Cardiomyopathy makes it harder for the heart to pump blood to the rest of the body. The condition can affect mitral valve function and may lead to regurgitation. Types of cardiomyopathy linked to mitral valve regurgitation include dilated cardiomyopathy and hypertrophic cardiomyopathy.
  • Damaged tissue cords. Over time, the pieces of tissue that hold the flaps of the mitral valve to the heart wall may stretch or tear, especially in people with mitral valve prolapse. A tear can cause blood leakage through the mitral valve suddenly and may require mitral valve repair surgery. A chest injury also can cause rupture of the cords.
  • Endocarditis. The mitral valve may be damaged by an infection of the lining of the heart (endocarditis) that can involve heart valves.
  • Radiation therapy. Rarely, radiation therapy for cancer that is focused on the chest area can lead to mitral valve regurgitation.

Risk factors

Several things can increase the risk of mitral valve regurgitation, including:

  • Certain infections that affect the heart
  • Heart attack
  • Heart problems present at birth (congenital heart defect)
  • History of other heart valve diseases, including mitral valve prolapse and mitral valve stenosis
  • Older age
  • Radiation to the chest

Complications

Mitral valve regurgitation complications often depend on the severity of disease. Mild mitral valve regurgitation usually does not cause any problems.

As mitral valve regurgitation gets worse, the heart must work harder to pump blood to the body. The strain on the heart can cause the left lower chamber to widen. The heart muscle may become weak.

Potential complications of severe mitral valve regurgitation include:

  • Irregular and often rapid heart rate (atrial fibrillation). Increased size of the upper left heart chamber (atrium) caused by mitral valve regurgitation may trigger this common heart rhythm disorder. Atrial fibrillation has been linked to an increased risk of blood clots and stroke.
  • High blood pressure in the lungs (pulmonary hypertension). Long-term untreated or improperly treated mitral regurgitation can increase pressure in the blood vessels in the lungs. As pressure rises, fluid builds up in the lungs.
  • Congestive heart failure. In severe mitral valve regurgitation, the heart has to work harder to pump enough blood to the body. The extra effort causes the left lower heart chamber (ventricle) to get bigger. Untreated, the heart muscle becomes weak. This can cause heart failure.

Mitral valve regurgitation care at Mayo Clinic

Feb. 08, 2022
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