What is Mitral Regurgitation?

– The information has been reviewed by Dr. Lo Ka Yip, David

Mitral regurgitation* (or “MR”) is a condition affecting one of the valves in your heart, the mitral valve#. The valves in your heart control the flow of blood through the four chambers of your heart. Each heart valve is made up of thin, but strong flaps of tissue. As blood flows through the four chambers of the heart, the valves open and close to ensure that blood flows in the right direction.

The mitral valve# is located between your heart’s two left chambers and allows blood to flow forward through your heart during a normal heart- beat. When the mitral valve# fails to close completely, blood flows backward in the opposite direction. This backward flow is called mitral regurgitation.

Mitral regurgitation places an extra burden on the heart, lungs, and other organs. Some patients may develop an enlarged heart because it has to work harder to pump blood through the body. Eventually, this extra burden can cause other, more serious problems to your heart (such as heart failure) and may result in irregular heart beats, stroke@, and even sudden death.

Image of 4-chamber heart affected by mitral regurgitation.
Yellow arrows show blood flowing backwards.

*Mitral regurgitation = A disorder of the heart in which the mitral valve does not close properly when the heart pumps blood, and blood flows backwards.
#mitral valve = A valve in the heart that lies between the left atrium and the left ventricle. The valve allows oxygen-rich blood to flow into the left ventricle, and then closes to prevent blood flowing back.
@stroke = The rapid loss of brain function(s) due to irregularities in the blood supply to the brain. This can be due to lack of blood flow, caused by blockage, or to hemorrhage (bleeding).

Causes of Mitral Regurgitation

There are several causes of mitral regurgitation. These include:
Heart disease (such as heart attack), or other conditions that weaken the heart muscle
Deterioration of valve tissue
Congenital valve abnormalities` (abnormalities present at birth)

`Congenital valve abnormalities = An abnormality that is present in a heart valve at birth. It may be related to valve size, shape, or an irregularity in the way the valve is attached to the heart.

Signs and Symptoms of Mitral Regurgitation

The signs and symptoms of mitral regurgitation* depend on how advanced it is and how quickly it has developed. Some patients may not experience symptoms, but when present they may include:
Shortness of breath, especially after exertion or when lying down

Fatigue and exhaustion, especially during increased activity
Cough, especially at night or when lying down
Sensations of a rapid, fluttering heartbeat
Swelling in your legs, abdomen or the veins in your neck

*Mitral regurgitation = A disorder of the heart in which the mitral valve does not close properly when the heart pumps blood, and blood flows backwards.

Options for Mitral Regurgitation Treatment

Treatment of mitral regurgitation* depends on how advanced the condition is and if the condition is getting worse. For mild cases, no treatment may be necessary, but you will need to be monitored regularly by your doctor. For more serious cases, surgery or less-invasive mitral valve# repair techniques may be required.

Medical Treatment
When needed, your physician may prescribe medicines that can help to make your symptoms more manageable. While these medicines manage your symptoms caused by mitral regurgitation*, they do not treat the defect in the mitral valve# itself.

Surgery
In some cases, your doctor may recommend surgical treatment to repair or replace the valve. mitral valve# repair preserves your own valve, while mitral valve replacement (performed when repair is not possible) replaces your damaged valve with an artificial one. Both valve repair and valve replacement require open-heart surgery.

Less-Invasive Valve Repair
In certain cases, your doctor may recommend a less-invasive treatment, such as MitraClip therapy, that does not involve open-heart surgery. Patients who have less-invasive valve repair usually have a shorter recovery time.

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