Mitral Regurgitation

What is Mitral Regurgitation?

The heart is comprised of four chambers, divided into two upper atrium and two lower ventricles. Blood travels through your body to the right atria, from there it passes into the right ventricle. From the right ventricle, it is pumped to your lungs. Once blood picks up oxygen in the lungs it returns to the left atria of the heart, to the left ventricle and from there out of the heart carrying blood rich with oxygen to the body.

Valves separate the chambers of the heart, carefully controlling how much blood goes where. The tricuspid valve separates the right atria from the right ventricle and the bicuspid valve, also known as the mitral valve, separates the left atria from the left ventricle. If the mitral valve gets damaged blood can flow the wrong way through the valve leading to a condition called mitral regurgitation. 

What can cause Mitral Regurgitation?

In the United States, the most common cause of mitral regurgitation is mitral valve prolapse, a condition most commonly seen in young women (ages 15-35) and in approximately 2-5% of the population. In developing countries, the most common cause of mitral regurgitation is rheumatic fever. A condition that can develop after a strep infection. Acute injuries to heart muscle such as a heart attack can also lead to mitral regurgitation.

What are the symptoms of Mitral Regurgitation?

Symptoms of mitral regurgitation often develop over time. They can be similar to heart failure and include difficulty breathing, fatigue, atrial fibrillation and high blood pressure. If the mitral regurgitation is secondary to a more acute injury like a heart attack, symptoms can include pulmonary edema and low blood pressure.

How is Mitral Regurgitation diagnosed?

The most useful noninvasive test to diagnoses mitral regurgitation is an echocardiogram, essentially an ultrasound of the heart, this allows the doctor to see how the heart is pumping blood and the backflow of blood unique to mitral regurgitation is clearly visible.

What are the differential diagnoses of Mitral Regurgitation?

  • Aortic regurgitation
  • Aortic stenosis
  • Mitral stenosis
  • Mitral valve prolapse
  • Pulmonary regurgitation
  • Pulmonic stenosis
  • Ventricular septal defect 

How is Mitral Regurgitation treated?

Medical therapy such as ACE inhibitors can be used to reduce the pressure in the heart, making it easier for blood to leave the heart and causing less blood to backflow into the left atria. If the amount of blood leaving the heart  (called the ejection fraction) is significantly lowered from a normal number of around 55-60% to below 30% as a result of the mitral regurgitation surgical repair is necessary. 

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