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What is Severe Mitral Valve Regurgitation?

written by: R. Elizabeth C. Kitchen • edited by: Diana Cooper • updated: 8/30/2010

Are you seeking more information on severe mitral valve regurgitation? If so, read on to learn about this condition.

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    Severe mitral valve regurgitation is a condition in which blood flows backward into the patient's heart due to the mitral valve not closing tightly enough. This condition is also referred to as mitral incompetence or mitral insufficiency. When this condition occurs, blood cannot efficiently go through the heart or to other parts of the body.

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    Causes

    Several things can cause this condition. When the cause is identified, it will make this condition easier to treat. Patients who are afflicted with any of the causes should always be aware that they could also develop this condition. The causes include:

    • Mitral valve prolapse
    • Rheumatic fever
    • Endocarditis
    • Damaged tissue cords
    • Wear and tear on the mitral valve
    • Untreated high blood pressure
    • Prior heart attack
    • Congenital heart defects

    Regardless of the cause, this condition can weaken the patient's heart making them more vulnerable to other heart conditions, including heart failure.

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    Symptoms and Possible Complications

    The symptoms a patient experiences depends on how quickly this condition progresses and how severe it is. These symptoms can include:

    • Heart murmur
    • Fatigue, specifically during activity
    • Cough, specifically when lying down or at night
    • Swollen feet or ankles
    • Shortness of breath, specifically when lying down or when exerted
    • Lightheadedness
    • Heart palpitations
    • Excessive urination

    Possible complications can include:

    • Heart failure
    • Endocarditis
    • Atrial fibrillation
    • Pulmonary hypertension
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    Diagnosis and Tests

    If a patient has the symptoms, and in some cases the causes, of severe mitral valve regurgitation, there are certain diagnostic tests they can have to determine if they have this condition. These tests include:

    • Echocardiogram
    • Electrocardiogram
    • Chest x-ray
    • Holter monitor
    • Exercise tests
    • Transesophageal echocardiogram
    • Cardiac catheterization
    • Chest CT scan
    • Magnetic resonance imaging
    • Cardiac color-doppler study
    • Radionuclide scans

    The doctor will also perform a thorough physical exam looking for signs and symptoms that are common when the right side of the heart fails. These symptoms can include enlarged liver, ankle swelling, heart murmur, and distended neck veins.

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    Treating this Condition

    When this condition is severe, treatment is almost always necessary. All patients will be regularly observed by their doctor, most often a cardiologist. They will be regularly evaluated on a schedule as determined by their doctor. Medications are very commonly used, but they cannot cure this condition. The fluid accumulation that often affects the legs and ankles causing them to swell often responds to diuretics. Fluid accumulation in the lungs can also be helped by diuretics. High blood pressure can often be treated by anti-hypertensive medications. Patients will also often be instructed to follow a low-salt diet to help control blood pressure and prevent fluid buildup.

    In the most severe of cases, and in cases where the patient does not respond to other treatments, surgery is often necessary. Surgery will replace or repair a damaged mitral valve. This surgery is performed via open-heart surgery. This is a major surgery and not all patients will be well enough to have this procedure done. If the patient waits too long to have surgery, the heart may have become too weak or be damaged beyond repair. Surgical procedures include:

    • Valve repair
    • Valve replacement
    • Minimally invasive mitral valve repair
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    Resources

    MayoClinic.com. (2009). Mitral Valve Regurgitation. Retrieved on August 25, 2010 from MayoClinic.com: http://www.mayoclinic.com/health/mitral-valve-regurgitation/DS00421

    MedlinePlus. (2010). Mitral Regurgitation – Chronic. Retrieved on August 25, 2010 from MedlinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/000176.htm