Mitral Valve Regurgitation

We understand that being diagnosed with a heart condition, such as mitral valve regurgitation, can be daunting, which is why we have put together this guide to help you learn more. If you have been looking for more information about mitral regurgitation, mitral valve regurgitation symptoms, and the best course of action for mitral regurgitation treatment, The Keyhole Heart Clinic (based in London, Essex and Nottingham) are on hand to provide you with all of the advice you need.

What Is Mitral Valve Regurgitation?

Mitral regurgitation is a condition in which your heart’s mitral valve does not close properly, allowing your blood to flow backwards in your heart. The blood travels back towards the left atrium and lungs as the left ventricle contracts, which means less blood is pumped around the body with each contraction of the heart. If the valve regurgitation is significant, the blood won’t be able to move through the body effectively, resulting in shortness of breath and tiredness. Mitral valve regurgitation is often referred to as leaky mitral valve by doctors to help patients understand the specific problem caused by this heart valve disorder.

In addition, blood travelling backwards results in dilatation and damage to the left atrium, leading to the development of atrial fibrillation. The lung vessels become damaged as the pressure within them increases, leading to pulmonary hypertension. Many of these sequelae become permanent over time, and the best course of action is to avoid them by early intervention.

Mitral Valve Regurgitation Symptoms

There is several symptoms of mitral valve regurgitation you may experience, caused by the blood flowing backwards into the left atrium. This can include:

• Shortness of breath (dyspnea), when lying down or during physical activity
• Palpitations, or the feeling of your heart racing or pounding
• Irregular heartbeat (arrhythmia)
• Sound of blood flow (heart murmur) across the valve
• Tiredness, fatigue and feeling weak
• Chest pain or discomfort
• Coughing, sometimes with bloody mucus
• Dizziness or fainting
• Leg, abdomen, or ankle swelling

Some people may not experience any Mitral Valve Regurgitation symptoms, especially if it is during the early stages. However, sometimes you may develop symptoms quickly with acute mitral valve regurgitation.

If you have any concerns over your heart health or experience any of these symptoms, you should speak to your doctor. They will be able to perform a physical examination and tests including an echocardiogram to diagnose the issue and provide treatment options if necessary. Arranging a heart screening service will allow a doctor to get to the bottom of the problem very quickly.

Mitral Regurgitation Causes

Your heart has four valves that keep the blood flowing consistently in the correct direction, and these are the mitral valve, tricuspid valve, aortic valve, and pulmonary valve. Each of these valves has flaps, otherwise known as leaflets or cusps, that open and close once during each heartbeat. If they don’t open or close properly, the blood flow can be disrupted.

Mitral valve regurgitation can be caused by various problems, such as:

• Mitral valve prolapse – a common heart issue where the mitral leaflets bulge back into the left atrium during contractions, preventing the valve from closing tightly.
• Damaged tissue cords – tissue cords that anchor the leaflets to the heart muscle may stretch or tear, causing a mitral valve leak.
• Rheumatic fever – this complication of untreated infection in early life could damage the mitral valve, leading to regurgitation later in life.
• Heart attack – this can damage the area of the muscle that supports the valve, affecting its function.
• Congenital heart defects – it is possible to be born with damaged heart valves.
• Endocarditis – the valve may be damaged by an infection of the lining of the heart.
• Atrial fibrillation – atrial fibrillation is a common heart rhythm problem that can be a potential cause of mitral or tricuspid valve regurgitation.

Potential Mitral Regurgitation Complications

When it is mild, mitral valve regurgitation usually does not cause any problems. However, severe mitral regurgitation can lead to complications, including:

• Atrial fibrillation – while this is a cause of regurgitation, it can also be a future complication. The stretching and enlargement of the left atrium may lead to this heart rhythm irregularity, causing blood clots that can travel to other parts of the body. In the brain, a stroke is the result.
• Heart failure – this can happen when your heart can’t pump enough blood to meet your body’s needs. Severe regurgitation places more strain on your heart and if the left ventricle continues to stretch without treatment, the heart could fail.
• Pulmonary hypertension – if you have untreated regurgitation, you could develop high blood pressure that affects the lung vessels. A mitral valve leak can increase pressure in the left atrium, which can eventually lead to pulmonary hypertension.

Mitral Regurgitation FAQs

How is mitral valve regurgitation diagnosed?

There are a variety of ways to test for mitral regurgitation, but the first step your doctor will take is to understand your medical history and perform a physical exam. This will involve listening to your heart with a stethoscope for a murmur. From there, your doctor will decide which tests are needed to make a diagnosis. This could include an echocardiogram, an electrocardiogram, a chest X-ray, a cardiac MRI, or cardiac catheterisation.

Can mitral valve regurgitation go away?

No, once the valve is damaged, it is unlikely to repair itself. This condition can either be acute, where the valve suddenly becomes leaky and the heart does not have time to adapt, or chronic, where the valve gradually becomes leakier over time, which may allow the heart time to adapt.

Mitral Regurgitation Treatment

There are a few courses of action available in relation to mitral regurgitation treatment London. There is the traditional method of heart surgery, or more minimally invasive keyhole mitral valve surgery options.

Minithoracotomy (no bone division)

The traditional approach to valve replacement is via a full breastbone break. While the results are good, patients will experience more pain and discomfort via this method, and will have a longer recovery time. Experienced surgeons at The Keyhole Heart Clinic can perform the same operation through a smaller cut under the nipple in men, and under the breast in women without breaking any bone. This is called a minithoracotomy. This wound would heal within 7 to 10 days with no need to cut any bone. This approach can be used to repair or replace the mitral valve. We can also perform atrial fibrillation ablation and repair the tricuspid valve at the same time of needed.

Here is a comparison of the two surgeries.

Catheter-based MitraClip insertion

This is a new percutaneous therapy that is suitable only for patients who are deemed too risky for traditional heart surgery, and is only of value in high risk patients who are unsuitable for traditional or keyhole heart surgery via minithoracotomy. Therefore, we would not recommend it to all patients, and will tell you which surgery is best for you during your consultation. The treatment involves clipping the two leaflets together to try and reduce the mitral valve leak, and offer patients who would otherwise be unsuitable for any treatment a degree of symptomatic relief.

We understand that it can be a stressful experience if you believe you are having symptoms or have recently been diagnosed. We want to make your experience as smooth and stress free as possible, so please do get in touch if you have any questions, queries or comments, and a friendly member of the team will get back to you as soon as possible. To find out more, contact our London Heart clinic or Essex Heart Clinic.

How long can you live with mitral valve regurgitation?

Early treatment is key with this condition. For those with a severe mitral valve leak surgery will allow improvement in symptoms and a longer life after surgery.

When should I get mitral regurgitation treatment?

In patients with certain types of mitral valve abnormality, repair is advised even in the absence of symptoms. Fixing the issue early on is key, so if you experience any mitral regurgitation symptoms you should consult a doctor as soon as possible.

If there is any doubt regarding the severity of the leak, then a test such as stress echocardiography (either medically induced or during mild exercise) is very valuable. Early surgery should certainly be performed if repair of the valve is possible, since this is far superior to replacement. If the valve is not repairable, then replacement should be considered when symptoms develop, or if there is evidence of heart enlargement, atrial fibrillation, or pulmonary hypertension.