Patient education: Mitral regurgitation (The Basics)

What is mitral regurgitation? — Mitral regurgitation is a condition in which one of the valves in the heart, called the mitral valve, leaks (figure 1).

When the heart valves are working normally, they keep blood flowing in only 1 direction. The valves work like swinging doors that open only 1 way – letting blood out, but not back in. Normally, little or no blood is able to leak backward. But if the valves are not working properly, more blood can go back in the direction it came from. This can cause problems.

The mitral valve normally keeps blood flowing from the left atrium to the left ventricle (figure 1). When it leaks, it lets blood flow back into the left atrium. A small (or "trace") amount of mitral regurgitation occurs in most healthy people, but this does not cause problems. Some people have larger amounts of mitral regurgitation, and this can get worse with time.

What are the symptoms of mitral regurgitation? — Most people with mitral regurgitation have no symptoms. But some people with severe mitral regurgitation have 1 or more of the following symptoms:

●Trouble breathing

●Tiredness

●Weakness

●Swelling in the ankles (figure 2), legs, or belly

Is there a test for mitral regurgitation? — Yes. If your doctor or nurse thinks you could have more than slight mitral regurgitation, they might order 1 or more of these tests:

●An electrocardiogram (ECG) – This test measures the electrical activity in your heart. It can show whether you have signs of abnormal heart muscle or had a heart attack in the past. These are some of the things that can cause mitral regurgitation.

●An echocardiogram (or "echo" for short) – This test uses sound waves to create a picture of your heart as it beats. It shows the size of the heart chambers, how well the heart is pumping, and how well the heart valves are working.

●A chest X-ray – A chest X-ray shows if there is fluid in the lungs. It also shows the general shape and size of the heart. Many people with severe mitral regurgitation have an enlarged heart.

How is mitral regurgitation treated? — If you have more than a trace amount of mitral regurgitation, your doctor might just keep an eye on you to see if it gets worse. If you have no symptoms, you might not need any treatment.

For those who do need treatment, options might include:

●Surgery to repair or replace the mitral valve

●A different procedure to repair the mitral valve – This involves inserting a thin tube called a "catheter" into a vein in the groin. The tube then goes up to the heart, and is used to put a special clip in the valve.

●Medicine or surgery to correct heart rhythm problems – People with mitral valve disease often have these problems.

●Medicines that make it easier for the heart to do its job

What if I want to get pregnant? — People with mitral regurgitation who have no symptoms or mild symptoms are often able to have normal pregnancies. But people who have symptoms with severe mitral regurgitation can have serious problems during pregnancy.

If you have mitral regurgitation and would like to get pregnant, talk with your doctor about it before you start trying. Some people need to have their mitral valve repaired or replaced before they try to have a baby.

More on this topic

Patient education: Echocardiogram (The Basics)
Patient education: What can go wrong after a heart attack? (The Basics)
Patient education: Mitral valve prolapse (The Basics)
Patient education: Prosthetic valves (The Basics)

Patient education: Mitral regurgitation (Beyond the Basics)
Patient education: Antibiotics to prevent heart valve infections (Beyond the Basics)