Mitral Valve Regurgitation
Mitral valve regurgitation often referred to as mitral regurgitation or mitral insufficiency or mitral dysfunction is a condition where your heart’s mitral valve fails to close properly which allows blood to flow backwards through the heart. When the regurgitation of your mitral valve has a significant amount it means that blood isn’t moving within your heart, or the outside in your body effectively which can cause you to feel tired or breathless.
The treatment of mitral valve regurgitation is dependent on how severe the condition is, if it’s worsening and if there are any symptoms. In the case of leakage that is not too severe treatments are usually not required.
It is possible that you will require heart surgery for repair, or replacement of the valve in case of extreme regurgitation or leakage. If left untreated with treatment, serious mitral valve regurgitation could lead to heart malfunction or heart rhythm issues (arrhythmias). Even people who aren’t experiencing symptoms could require a medical evaluation from an experienced surgeon and cardiologist in mitral valve diseases to determine if an early intervention is beneficial.
A few people suffering from mitral valve diseases may not notice symptoms for a number of years. The signs as well as symptoms for mitral valve dysfunction that depend on the extent and speed at which the condition is diagnosed, may include:
- A heart sound that is not normal (heart murmur) can be heard using the Stethoscope
- Breathlessness (dyspnea) particularly when you’ve been extremely active or lying down
- Heart palpitations are the sensations of a fast heartbeat that is fluttering
- A swollen ankle or foot
Mitral valve regurgitation is usually slow and mild in its progression. There may be no signs for years, and you may not even know you suffer from this condition. It may not get any worse.
The doctor may first think that you suffer from mitral valve regurgitation when they detect an abnormal heart murmur. In some cases, however, the problem can be diagnosed quickly and you might be greeted with a sudden increase in extreme symptoms and signs.
When is the best time to seek medical help?
If your doctor detects a heart murmur while listening to your heart via the stethoscope, he/she might suggest that you see a cardiologist and obtain an echocardiogram. If you experience symptoms that indicate mitral valve regurgitation, or another issue within your heart, you should consult your physician immediately. The first signs are actually the signs of the mitral valve’s complications which include heart failure, an illness in which your heart isn’t able to pump enough blood to meet the demands of your body.
The heart contains four valves to ensure that blood flows in the right direction. The valves are the mitral valve the tricuspid valve as well as the pulmonary valve and the an aortic valve. Each valve is equipped with flaps (leaflets or cusps) which open and close at the same time every heartbeat. Sometimes, valves don’t fully close or open and can cause disruption to blood flow through your heart and into your body.
In mitral valve regurgitation the valve that connects the left heart chamber’s upper (left atrium) and the lower left heart chamber (left ventricle) does not close properly which causes blood to leak backwards to the atrium of left (regurgitation).
Causes of Mitral Valve regurgitation
Mitral valve regurgitation may be caused by issues in the mitral valve which is also known as primary mitral regurgitation of the valve. The left ventricle is a part of the body that suffers from diseases. may cause functional or secondary mitral valve regurgitation.
The possible reasons for mitral valve regurgitation are:
- Prolapse of the mitral valve. In this condition the leaflets of the mitral valve expand back to the left atrium during an exercise of the heart. This is a common heart defect that may hinder the mitral valve from closing completely and cause regurgitation.
- Cords of tissue that are damaged. Over time, the tissues cords that hold dies on the mitral valve the heart wall can be stretched or tear, particularly for those suffering from Mitral valve prolapse. A tear could result in leakage from the valve abruptly and may require repair via heart surgery. A chest injury may cause the cords to rupture.
- Rheumatic fever. Rheumatic fever -is a complication of untreated strep throat, can cause damage to the mitral valve and lead to mitral valve regurgitation in the early or later in the course of. Rheumatic disease is now uncommon within the United States, but it’s still common in the developing world.
- Endocarditis. The mitral valve could be damaged due to an infection in the heart’s lining (endocarditis) which may affect the heart valves.
- Heart attack. A heart attack may cause damage to the heart muscle that is responsible for supporting the valve that is mitral, which can affect its function. In the event that the damages are severe enough that a heart attack occurs, it can cause severe and sudden mitral valve regurgitation.
- Abnormality in the cardiac muscle (cardiomyopathy). Over time, certain ailments like high blood pressure can trigger your heart muscle to work harder, eventually expanding your left ventricle of your heart. This may cause the tissue to stretch surrounding your mitral valve that can cause leakage.
- Trauma. Experiencing trauma, like an accident in the car could result in the mitral valve to regurgitate.
- Congenital heart imperfections. Some babies are born with heart defects that include damaged heart valves.
- Certain medications. Prolonged use of certain drugs can result in mitral valve regurgitation, for instance those that contain Ergotamine (Cafergot, Migergot) that are used to treat migraines , among other ailments.
- Treatment for radiation. In rare cases the treatment of cancer with radiation targeted at the chest region can cause mitral valve regurgitation.
- Atrial fibrillation. Atrial fibrillation is a common heart rhythm disorder which could be a source of regurgitation in the mitral valve.
Certain factors can increase the risk of developing mitral valve regurgitation The most common causes are:
- A background of prolapsed mitral valve or stasis. However, having one of the conditions does not necessarily indicate that you’ll be prone to developing regurgitation of the mitral valve. A history of valve diseases increases the chances of developing.
- Heart attack. A heart attack could cause damage to your heart, altering the function of your mitral valve.
- Heart diseases. Certain forms of heart disease, like coronary artery disease can cause the mitral valve to regurgitate.
- The use of certain medicines. People who take medicines that contain ergotamine (Cafergot, Migergot) as well as similar migraine medications or take cabergoline also have an increased chance of suffering from mitral regurgitation. Similar issues were observed in the appetite suppressants fenfluramine and dexfenfluramine. Both are no longer available for sale.
- Infections, such as endocarditis and Rheumatic fever. Infections or the inflammation that they trigger can cause damage to the mitral valve.
- Heart disease that is congenital. Some people are born with an abnormal mitral valve, which is susceptible to regurgitation.
- age. By middle age there are many who suffer from mitral valve regurgitation due to natural degeneration of the valve.
If it’s minor mitral valve regurgitation generally doesn’t cause any issues. However serious mitral valve regurgitation may cause complications, such as:
- Heart Failure. Heart failure results when your heart isn’t able to supply enough blood to meet the demands of your body. Mitral valve regurgitation is severe and puts additional strain on the heart due to the fact that, when blood pumps backwards and forward, there’s less blood flowing forward each time you beat. The left ventricle grows and, if not treated gets weaker. This could lead to heart failure.Additionally, pressure builds up in your lungs, causing the accumulation of fluid, which can strain both sides of your heart.
- Arial fibrillation. The stretching and expansion of the left atrium in your heart could cause this irregular heartbeat that makes you heart’s upper chambers beat in a chaotic manner and quickly. Atrial fibrillation may cause blood clotsto form, which could break free from your heart and move across your body, causing severe issues, like strokes if a blockage of a blood vessel within your brain.
- The pulmonary hypertension. If you have persistent, untreated, or untreated mitral regurgitation, you could develop a form of high blood pressure which impacts the vessels in the lung (pulmonary hypertension). A leaky valve in the mitral chamber can cause pressure to rise inside the left atrium which could eventually lead to the condition known as pulmonary hypertension. This could cause heart problems in the left side of the heart.
Key diagnostic points
- It could be unaffected for years (or for the rest of life).
- Severe mitral regurgitation may cause left-sided heart failure.
- In the case of chronic mitral regurgitation primary, surgery is recommended for symptoms, or when the LV ejection percentage (LVEF) lower than 60 percent or the echocardiographic LV end-systolic size is more than 4.0 cm.
- For patients with mitral prolapse or severe mitral regurgitation surgery is suggested when mitral repair is carried out.
- Patients suffering from functional mitral regurgitation can be improved by biventricular pacing. Some might require surgical intervention.
The doctor will inquire questions about the medical background of you as well as the background of family members with heart problems. The doctor will also conduct an examination that involves the heart’s activity using an instrument called a stethoscope. Mitral valve regurgitation typically produces the sound of blood flowing backwards from the valve (heart murmur).
The doctor will decide the tests needed in order to determine an assessment. If you need to test for a diagnosis, you might be sent to a cardiac surgeon.
The most common tests used to diagnose regurgitation of the mitral valve include:
- Echocardiogram. This test is frequently used to detect Mitral valve regurgitation. In this test the sound waves directed towards your heart by a wand-like device (transducer) that is placed on your chest generate videos of your heart moving.The test examines the heart’s structure as well as the mitral valve, and the flow of blood throughout your heart. A cardiac echocardiogram can help your doctor take a closer look at the mitral valve and assess how it’s performing. Doctors may also use an echocardiogram that is 3D.Doctors can conduct a different kind of echocardiogram referred to as an echocardiogram transesophageal. In this kind of test it is performed using a tiny transducer to the tube’s end is passed down your stomach, which permits to see more closely the mitral valve, which is different from what an echocardiogram that is normal.
- Electrocardiogram (ECG). Wires (electrodes) that are attached to pads on your skin detect the electrical signals coming from your heart. An ECG will detect an enlarged chamber within your heart. It can also detect heart diseases and irregular heart rhythms.
- Chest Xray. This enables your physician to determine if your left atrium or left ventricle are enlargedpotential indicators for mitral valve regurgitationas well as the health of your lung.
- Heart imaging. A cardiac MRI makes use of radio waves and magnetic fields to create precise photographs of your heart. The test can be used to assess the extent of your illness as well as determine the size and functionality of your left heart’s lower chamber (left ventricle).
- Cardiac CT. A CT angiogram can be taken of the abdomen, chest and pelvis to determine if you’re an ideal candidate of a robotic repair for your mitral valve.
- Tests for exercise or stress test. Different exercise tests allow you to measure your tolerance to activity and assess your heart’s reaction to physical effort. If you’re not able to exercise, medicines that simulate the effects of exercising on your heart could be considered.
- Catheterization of the cardiac. This test isn’t commonly used to detect the condition of mitral valve regurgitation. This procedure is invasive and involves threading a small tubing (catheter) through the blood vessel of your groin or arm to an artery inside the heart, and then injecting dye into the catheter, making the arterial artery visible in an X-ray. This gives you a clear image of the arteries in your heart and how your heart function. It also allows you to measure the pressure inside your chambers of your heart.
The treatment for regurgitation of the mitral valve varies on how severe your situation is, whether you’re experiencing symptoms or signs or if the condition is becoming worse. The aim for treatment is to enhance the heart’s performance while reducing your symptoms and signs and preventing any further complications.
A doctor who is trained to treat heart conditions (cardiologist) will offer your medical care. If you suffer from the condition of mitral valve regurgitation think about getting treatment in a medical facility that has an multidisciplinary team of doctors and medical professionals who are trained and adept at evaluating the heart valve and treating diseases. The team will work closely with you in determining the best course of treatment for your situation.
Monitering mitral regurgitation
A few people, specifically those who have mild regurgitation may not require treatment. However, it is possible that the condition will need to be monitored by your doctor. There may be a need for regular assessments and the frequency will depend on your illness. Your physician may also suggest taking steps to improve your lifestyle.
Your physician may prescribe medication to treat the symptoms but medication cannot treat mitral valve regurgitation.
The medications may comprise:
- Diuretics. These medications can help to reduce the accumulation of fluid in the lungs or your legs and can cause mitral valve regurgitation.
- blood thinners. These medications can aid in preventing blood clots, and could be used in the event that you suffer from atrial fibrillation.
- Blood pressure medication. High blood pressure can cause mitral valve regurgitation to be more severe If you suffer from excessive blood pressure, your physician may prescribe medication to lower it.
Your mitral valve might require repairs or replaced. Doctors might suggest mitral valve replacement or repair even if there aren’t any symptoms, since this could help prevent complications and improve the outcome. If you require surgery due to other heart conditions Your doctor could replace or repair the damaged mitral valve in the same procedure.
Mitral valve surgeries are generally carried out by cutting (incision) within the chest. In certain instances, surgeons may perform minimally invasive surgery, which requires the making of smaller incisions than those utilized in open heart surgery.
Some medical facilities may carry out robot-assisted heart surgery, which is a form that is minimally-invasive. In this kind of procedure surgeons observe the heart with an enhanced high-definition 3D view using a video monitor. They also employ robotic arms to mimic certain procedures used in open heart operations.
The doctor will be able to discuss with you what mitral valve replacement or valve replacement might be suitable for your particular situation. Doctors might also assess your health to determine if you’re eligible for minimally-invasive heart operation or open-heart surgery.
Doctors may suggest repair to the mitral valve because it protects your valve and can preserve your the heart’s function. If mitral valve repair isn’t feasible doctors might have to replace the mitral valve¹.
Repair of the Mitral valve
Surgeons can fix the valve by reconnecting the valve flaps (leaflets) and replacement of the cords that support the valve or by removing the valve’s excess tissue so that the leaflets close securely. Surgery may be used to strengthen or tighten the ring around the valve (annulus) by implanting an artificial rings (annuloplasty bands).
Doctors might make use of long narrow tube (catheters) to fix the valve of the mitral in certain situations. In one procedure using catheters surgeons insert a catheter that has clips that are inserted into an artery inside the groin. They then direct it into the valve in your mitral. Doctors make use of the clip to modify the shape of the valve. Patients with severe signs caused by mitral valve regurgitation that aren’t candidates for surgery or have an increased risk of surgery may be considered for this procedure.
In another way doctors can fix a previously repaired mitral valve which is leaky through the use of a device to stop the leakage².
Mitral valve replacement
In the event that your valve cannot be repaired, it could require replacement of the mitral valve. When you undergo mitral valve replacement, your surgeon will remove your damaged valve, and then replaces it by a mechanical valve or a valve made of human, cow or pig the heart (biological tissue valve).
The valves of biological tissue degrade in time, and eventually require replacement. Patients with mechanical valves are required to be on blood thinners to keep them from getting blood clots.
Your doctor will be able to discuss the benefits and risks of each kind of heart valve and decide which one would be suitable for your needs.
Doctors continue to research catheter procedures that fix or repair mitral valves. Some medical facilities may provide mitral valve replacement as part of an intervention with a catheter within a clinical study for patients suffering from severe mitral valve diseases who aren’t candidates for surgery. A catheter procedure could be utilized to place an alternative valve into the biological tissue replacement valve that’s not functioning as it should.
Consult your doctor about the kind of follow-up treatment you’ll need following your surgery and inform your doctor when you begin experiencing new symptoms or symptoms become worse following treatment.
Lifestyle and home remedies for home
The doctor might suggest that you make a variety of healthy lifestyle changes for your heart to your routine, including:
- Maintaining your blood pressure in check. Control of high blood pressure is essential for those suffering from Mitral Valve Regurgitation.
- A heart-healthy diet. Food doesn’t directly influence the regurgitation of the mitral valve. However, a healthy diet could assist in preventing heart diseases that could cause weakness to the muscle of your heart. Choose foods that are free of trans and saturated fats as well as salt, sugar, and refined grains like white bread. Take a wide assortment of fruits and vegetables as well as whole grains and protein sources, like fish, lean meats and nuts.
- Maintaining an appropriate weight. Keep your weight within the recommended range set by your physician.
- Preventing the infective endocarditis. If you have been through a replacement of your heart valve or repaired, your physician may suggest that you take antibiotics prior to dental procedures to avoid an infection known as infective endocarditis. Consult your physician to determine whether he or she suggests that you take antibiotics prior to dental procedures.
- Reduce your consumption of drinking alcohol. Heavy alcohol use may cause arrhythmias, and cause symptoms to become more severe. Drinking excessively can cause cardiomyopathy, which is a condition of weakening the heart muscle which causes mitral regurgitation. Talk to your physician about the consequences of drinking alcohol.
- Do not smoke. If you smoke stop now. Consult your physician about options to help you stop smoking. Participating in a support group could be beneficial.
- Regular physical activities. How long and how hard you’re able to work is contingent depending on your health condition along with the amount of your exercise. Consult your physician prior to beginning your exercise routine in particular if you’re planning to participate in playing competitive sports.
- Regularly visiting your doctor. Establish a regular examination schedule with your cardiology or primary care doctor. Inform your doctor if you notice an increase or decrease in health signs or symptoms.
If you’re a woman suffering from Mitral Valve Regurgitation you need to speak with your doctor prior to becoming pregnant. The heart is triggered by pregnancy and has to be more active. The extent to which a heart that has mitral valve regurgitation copes with this additional work is dependent on the extent of regurgitation as well as the efficiency your heart is pumping. Through your pregnancy and following the birth, your cardiologist as well as your obstetrician must be on the lookout for your.