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Mitral Valve Regurgitation: Diagnosis & Treatment

Mitral valve regurgitation is a condition that occurs when one of the valves in your heart leaks, allowing blood to flow backward through the heart and toward the lungs. Mild cases can be harmless, but more severe cases can make your heart inefficient and cause symptoms that need medical or surgical treatment. A doctor can diagnose the condition with painless, non-invasive tests.

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

Surgical repair or replacement of the mitral valve can often provide a long-term solution for mitral valve regurgitation, offering durable treatment and the potential for returning to a normal life expectancy. In certain cases, less invasive surgical and catheter-based treatments may also be suitable. These technologies are continuously advancing.

Trace and mild cases of mitral regurgitation aren't usually cause for worry, especially in the short term. If your doctor diagnoses you with trace or mild mitral regurgitation, you should get regular checks to see how it progresses, but you may not have symptoms, and it probably won't interfere with your day-to-day life.

In about half of patients, mitral valve regurgitation progresses (gets worse over time), but about 11% of patients experience spontaneous regression of the condition and improvement of symptoms.

Important signs of mitral regurgitation include shortness of breath, heart palpitations, and swelling in your extremities, and weight gain. Learn more about the causes and symptoms of mitral valve regurgitation.

Mitral valve regurgitation can worsen with lifestyle factors under your control, including:

  • Bad diet
  • Insufficient exercise
  • Poor or insufficient sleep
  • Alcohol, tobacco, and illegal drugs

High blood pressure can also worsen mitral regurgitation, but can be mitigated with medicines and the same lifestyle factors that improve mitral regurgitation.

Also, while exercise is an essential preventative measure for heart disease, mitral regurgitation makes physical activity more difficult. Talk to your doctor about an exercise regimen or any training you plan to pursue. Depending on the progression of your condition, they may recommend avoiding high-intensity exercise or competitive sports.

Learn more about the benefits of regular exercise for heart health.