Mitral Valve Regurgitation: Diagnosis & Treatment

How is mitral valve regurgitation diagnosed?

To diagnose mitral valve regurgitation, your doctor will perform a physical exam. They'll listen to your heart with a stethoscope, ask you about symptoms of mitral valve regurgitation, and check for swelling, especially in the extremities. If they suspect mitral regurgitation, they'll order tests to confirm the condition.

The most common test is an echocardiogram. It relies on the same technology as the ultrasound device used to see babies in the womb. A sonographer will use an ultrasound machine to look at your heart in real-time. They'll be able to see the action of your heartbeat and the flow of blood.

Sometimes, your doctor may need an echocardiogram from inside your body to see the valve more clearly. This is called a transesophageal echocardiogram. You'll be sedated, and the sonographer will insert a thin tube with an ultrasonic probe into your throat to get a better view.

Other possible diagnostic tests include:

• CT scan: A 3D X-ray that shows your heart from all angles.
• MRI: A test using magnetic fields to produce high-quality images of the heart.
• Exercise tests: Stress tests, such as walking on a treadmill or riding a stationary bike, can provide information about how your heart performs during exercise.
• Cardiac catheterization: Catheterization techniques allow doctors to insert special tools into your arteries. They may use this technique to get a different view of what's happening inside your heart or to place dyes that make the heart show up more clearly on other scans.

How fast does mitral valve regurgitation progress?

It isn't easy to give a definitive timeline. The speed at which mitral valve regurgitation progresses depends on the cause of your mitral regurgitation and factors such as your age, medical history, and lifestyle. An echocardiogram can allow doctors to track the amount of blood that leaks through the valve and monitor the progression of your individual case.

The severity of your case will determine how often you need to have your heart checked with an echocardiogram. Mild cases may be monitored every 3-5 years. As the condition progresses, you'll get checks more frequently.

Mitral valve regurgitation treatments

The treatment of choice for mitral regurgitation depends on the cause and stage of the condition. There are four stages of mitral regurgitation:

• Stage A (at risk): You're at risk for mitral regurgitation but don't have the condition yet.
• Stage B (progressive): Your valve disorder is mild, and you don't have symptoms.
• Stage C (asymptomatic severe): Your valves show more severe leakage, but you don't have significant symptoms.
• Stage D (symptomatic severe): You have severe valve disease and noticeable symptoms.

Mild mitral regurgitation treatment

Trace and mild mitral valve regurgitation may not require treatment. Often, the mildest forms of the condition don't cause discomfort and don't interfere with the heart's function in significant ways. As mitral valve regurgitation progresses, you may need treatment.

Severe mitral valve regurgitation treatment

In more severe cases of mitral valve regurgitation, treatment may be necessary to improve symptoms or to avoid serious complications.

Treatments for mitral valve regurgitation without surgery can include medicines called beta-blockers and ACE inhibitors (which lessen the workload on the heart), medicines that slow your heart rate, and medicines to manage symptoms like swelling.

As your condition progresses, surgery may be the best option to reduce symptoms and lower your risk of serious complications like atrial fibrillation, which can cause strokes. Modern surgical treatment for mitral valve regurgitation uses minimally invasive techniques when possible, to reduce your recovery time and complications. Possible surgical options include:

• Mitral valve repair: Your surgeon will fix the valve dysfunction by adjusting the position of the flaps, trimming the flaps if they're too large, or adding clips or other tools to help the valve work correctly.
• Mitral valve replacement: When the valve can't be repaired, the surgeon can replace your defective valve with a new one. The new valve can be synthetic (an artificial valve made from carbon and metal) or organic (made with transplanted tissue from an animal or another person). Synthetic valves last a long time—up to 30 years—but require you to take blood thinners. Organic valves last about half as long but don't require blood thinners. Your doctor can advise you on the best choice for your particular case.

If your doctor determines you're at risk of severe complications, they may recommend surgical treatment for mitral regurgitation even if you don't have symptoms.

FAQs about mitral valve regurgitation