What are the other Names for this Condition? (Also known as/Synonyms)

• MI (Mitral Incompetence)
• Nonrheumatic Mitral (Valve) Incompetence, NOS
• Prosthetic Mitral Valve Regurgitation

What is Mitral Valve Regurgitation? (Definition/Background Information)

• The heart pumps blood in and out of the heart. There are valves that prevent the blood from flowing the wrong way. If due to any reason, the valve (specifically the mitral valve located on the left ventricle that controls the blood flow out of it, into the left atrium) does not close properly, then there is a backward flow of blood into the atrium (called regurgitation). This condition is known as Mitral Valve Regurgitation
• Since there is a decreased amount of blood being supplied, the heart increases its blood pumping rate, leading to a heart failure. This heart valve disorder is frequently seen among elderly individuals, and is generally a very common condition
• This health problem is caused by many heart-linked factors or secondary infections that weaken the heart muscles. The condition may occur suddenly, or the individual may chronically suffer from this heart abnormality
• Mitral Valve Regurgitation, also Mitral Regurgitation, may be of varying intensity. Acute cases of the condition may prove to be fatal, if immediate medical attention is not administered

Who gets Mitral Valve Regurgitation? (Age and Sex Distribution)

• Mitral Valve Regurgitation is generally observed with an advancing age - over the age of 55 years
• However, women are more prone to suffer this defect

What are the Risk Factors for Mitral Valve Regurgitation? (Predisposing Factors)

Some of the potential risk factors for Mitral Valve Regurgitation are:

• Any damage to the heart valves, such as caused by endocarditis infection, rheumatic heart disease, swelling of the heart ventricles
• Stress and other physical factors causing a high blood pressure, or leading to a coronary heart disease
• Certain diseases and disorders may cause the heart valves to widen. These include syphilis, Marfan syndrome, ankylosing spondylitis (a skeletal defect of the vertebrae), etc.
• Family medical history of Mitral Regurgitation
• Use of certain weight-loss drugs, such as appetite suppressants, over a period of time

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Mitral Valve Regurgitation? (Etiology)

Mitral Valve Regurgitation is caused due to a variety of factors. Chiefly these include:

• Any heart valve abnormalities, such as a mitral valve prolapse
• Ischemic heart diseases, leading from reduced blood supply
• High blood pressure may damage the heart
• Narrowing of blood vessels supplying blood to the heart; a condition called as a coronary heart disease
• Rheumatic heart condition
• Injury to the heart valve, trauma
• Advancing age is a significant factor that causes a deterioration of the mitral valves
• Heart failure
• Infection of the heart - endocarditis
• Syphilis, Marfan syndrome, ankylosing spondylitis, etc. may cause a widening of the heart valves

What are the Signs and Symptoms of Mitral Valve Regurgitation?

Mitral Valve Regurgitation can present itself without any symptoms, for a long period of time. There is also a possibility that it may suddenly develop to life-threatening proportions. Some of the signs and symptoms include:

• Severe to critical cases of Mitral Regurgitation are seen to occur, if there is a heart attack
• Irregular heartbeat patterns, heart palpitations
• Coughing due to breathing trouble, or shortness of breath, or rapid breathing; even while sleeping, or quite unexpectedly without much exertion
• Fatigue while exercising, or sometimes while in bed
• Fluid accumulation in the feet and ankles, giving it a swollen appearance
• Frequent necessity to pass urine
• Sometimes, during treatment, the following signs and symptoms may be observed, which require medical attention. These include:
  • Feeling chilly, fever
  • Discomfort
  • Muscle aches and headaches

How is Mitral Valve Regurgitation Diagnosed?

Early detection and treatment of Mitral Valve Regurgitation is essential; since with time, the valve condition may progress from being a mild case to a severe, chronic one.

A physical evaluation of the individual’s heart and body condition is undertaken, once the physician suspects the disorder. The basic sequence of diagnosis is:

• Listening to the heartbeat, using a stethoscope, to detect any unusual sound (blood leakage through the valve, abnormal beats/sounds, heart murmur, sound of fluid in the lungs)
• Test pulse rate and blood pressure values
• Evaluation of personal and family history for related heart conditions

A cardiologist may then plan the type of tests that are required. Sometimes, various exercises are used to measure the heart’s response to physical activities.

• A pulmonary x-ray may reveal a swollen left ventricle - the size and shape of the heart can be studied
• Echocardiogram and MRI of the heart, are a few of the common imaging studies used
• A catheter may be inserted into the left ventricle of the heart to study/diagnose the condition, if the heart function is not encouraging
• A picture of the heart and the aorta is obtained by passing a transducer (like an endoscope), through the esophagus. This method is used to understand the condition of the heart and aorta and is called transesophageal echocardiogram
• Differential diagnosis to rule out other conditions should be considered before arriving at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Mitral Valve Regurgitation?

Complications due to mild Mitral Valve Regurgitation are generally rare. But, if the condition is severe, then the effect of the condition could be serious. The complications include:

• Congestive heart failure
• Endocarditis - a kind of heart infection caused by inflammation of the heart walls or inner linings
• Cardiac arrhythmias, when the heart beats irregularly, and which can be fatal at times
• Blood clots may develop that may travel to other vital organs, like the brain and lungs. This is called thromboembolism

How is Mitral Valve Regurgitation Treated?

Treatment of Mitral Valve Regurgitation is based on the condition of the heart, the overall health status of the individual, and the signs and symptoms presented (whether they are mild, moderate, or severe):

• Surgical procedures, to either repair or replace the heart valves are normally resorted to, when the symptoms due to heart dysfunction are severe
• Surgery is also advocated to prevent Mitral Valve Regurgitation from progressively worsening and creating life-threatening situations
• Individuals with moderate symptoms can be helped by administering medications, such as:
  • ACE inhibitors/beta-blockers
  • Anticoagulants to prevent blood clots
  • Drugs to control arrhythmias
  • Diuretics (substances that increase the rate of fluid flow from the body - also called water pills), to keep the signs and symptoms under control, and to also control any fluid build-up
• If the individual presents with mild symptoms, then regular and periodic evaluation of the condition (using an echocardiogram) is prescribed; being vigilant is of importance here
• Avoidance of stressful situations and physical activities, which help in keeping the blood pressure regularly under control, are particularly important
• Having a low-sodium diet is recommended, and so are periodic visits to one’s cardiologist

How can Mitral Valve Regurgitation be Prevented?

Individuals with Mitral Valve Regurgitation, have to always maintain their blood pressure under control and within acceptable levels, to prevent deterioration of valve regurgitation. A few preventive measures include:

• Germs in the bloodstream, due to poor oral hygiene, are a leading cause of endocarditis - a heart condition that causes damage to the heart valves. Hence, keeping the gums and teeth in good hygienic condition (good oral hygiene) is essential
• Rheumatic fever is said to cause Mitral Regurgitation. Therefore, taking care of your sore throat or bacterial throat infection, is one way to ensure that rheumatic fever does not develop
• Smoking has to be completely avoided
• Follow a healthy diet for the heart
• Maintain a healthy weight and avoid obesity
• Promptly treat any conditions, which may be causal factors for Mitral Valve Regurgitation

What is the Prognosis of Mitral Valve Regurgitation? (Outcomes/Resolutions)

• Mild forms of Mitral Valve Regurgitation may be asymptomatic and may not be noticed. However, they might still require medical attention and evaluation by one’s healthcare provider
• For severe cases, surgical intervention is recommended - this can rectify the condition, if no additional complications develop
• If treatment is delayed or is not provided, then it may be fatal for individuals with a heart failure, or those suffering from other heart conditions

Additional and Relevant Useful Information for Mitral Valve Regurgitation:

A healthy lifestyle improves the quality of heart life. Light exercising (walking, swimming, as recommended by the physician), periodic health check-ups (both with a cardiologist and a dentist), keeping blood pressure under control, and using less oil and salt in the diet, are all good health practices.