Mitral regurgitation
What is mitral regurgitation?
Mitral regurgitation occurs when the mitral valve doesn’t fully close or leaks. As a result, some blood flows back into the atrium rather than collecting in the ventricle to be sent out into the body. This can make the heart work harder, causing the ventricle chamber to widen and the heart muscle to weaken.
Moderate to severe mitral regurgitation is the most common type of valve disease. Mild cases are very common and often require no treatment.
Mitral Regurgitation
The valve doesn’t fully close & leaks
Causes
Causes of mitral regurgitation include:
Mitral prolapse, where part of the mitral valve bulges so it can’t close evenly
Calcium buildup on or around the mitral valve
Heart attacks and heart damage
Heart failure
Radiation therapy
Sudden cases of acute mitral regurgitation can be caused by:
Endocarditis
Chest trauma (e.g. car accident, heart attack)
Symptoms
Symptoms may be difficult to recognize, as they vary and are often dismissed as general signs of aging. Common symptoms include:
Shortness of breath or fatigue
Irregular heartbeat
Dizziness
Make sure you monitor any changes using a symptom tracker and attend regular checkups with your healthcare provider.
Treatments
If your valve requires treatment, a range of options may be available. Your heart team should carefully explain the risks and benefits of each approach for you. Together, you and your heart team can make the best decision about the right treatment for you. Treatment options may include:
Mitral valve repair
Mitral valve repair is the most common way of treating primary mitral regurgitation and can preserve the natural pumping function of the heart.
Repair Includes the surgical reshaping, patching or replacement of chords supporting the mitral valve.
Annuloplasty is a procedure where a small plastic ring is sewn into the base of the cusps or flaps to restore the shape of the valve opening.
Transcatheter mitral valve repair (TMVr) or transcatheter edge-to-edge repair (TEER) is a minimally invasive procedure in which a thin tube called a catheter is used to insert devices to bring the edges of the valve together. This helps the valve close more completely, reducing regurgitation (back flow).
Surgical mitral valve replacement
A surgical valve replacement is usually performed by open heart surgery or, if possible, minimally invasive surgery with smaller incisions. The surgeon removes the aortic valve and replaces it with either a mechanical valve or a tissue valve, which is sometimes called a bioprosthetic or biological valve.
When deciding which valve is right for you, here are some factors to consider:
Mechanical valves are made of carbon or metal and are very durable – they can last a lifetime. This means it is less likely that you will need a second valve replacement.
With a mechanical valve, you will need to take blood-thinning medications every day for the rest of your life, to reduce the risk of blood clots forming in the valve.
Blood thinners increase your risk of bleeding which is important if some of your daily activities, such as your job or hobbies, increase your risk of falls, bumps or bruises.
Mechanical valves may make a clicking sound that you may be able to hear.
Bioprosthetic valve replacements are made of animal tissue that is strong and flexible enough to last 10-15 years.
They usually don’t require high doses of long-term blood-thinning medications which means your risk of bleeding is lower.
There is a higher chance you may need another operation with a bioprosthetic valve.
Lifestyle changes
With all heart valve diseases, healthy habits can improve your health generally and reduce the strain on your heart from everyday activities. Maintaining a healthy weight, stopping smoking, and starting light exercise like walking can help your heart adapt to work better despite valve disease.
Medical management
Regular checkups to monitor your heart health.
Your heart team may prescribe medications to relieve your symptoms, reduce complications and/or manage risk factors. Medicines are not a cure for heart valve disease.
In some cases, management will focus on treating damage to the left ventricle, which could include medication for heart failure or a special pacemaker to support the function of the ventricle.
There is a lot to consider when deciding on treatment. These resources will help you ask the right questions and participate in decision making with your heart team.
Patient Stories
If you have been diagnosed with mitral regurgitation, you are not alone. Learn from people who share their experience — and what they learned about diagnosis, treatment and recovery.
Frequently asked questions
I have recently been diagnosed with heart valve disease, do I need to restrict my physical activity?
Living with heart valve disease means that one or more of your valves don’t work the way they should, which may have you questioning how an exercise program might impact your heart and overall health.
It’s important for people with heart valve disease to engage in physical activity; exercise is good for your heart and your overall health. However, advice may vary depending on the severity of the disease and which valve is affected. Your healthcare provider can advise you about your specific case.
If you have mild heart valve disease, regular exercise, including strength training, reduces your risk of developing other health conditions such as cardiovascular disease, diabetes, and even some kinds of cancer. In addition, regular physical activity prior to a heart valve repair or replacement will help make your recovery easier.
The most important consideration when doing any kind of exercise is to pay attention to any symptoms you experience, such as shortness of breath or feeling dizzy. If these occur during exercise, it means you need to slow down.
• Use our symptom tracker
If you try strength training, make sure you get proper guidance and start slowly. Simple activities, such as walking or cycling, can be some of the most effective. Exercising with friends means you are more likely to have fun and stick to your exercise plan. Using an activity tracker, such as a smartwatch, is also a great strategy to keep you motivated.
If I have no symptoms, does that mean my heart valve disease is mild?
No. You can have severe valve disease and feel fine. That’s why it is important to have a healthcare provider to assess your heart regularly.
What do I do if my doctor detects a murmur?
If your healthcare provider detects a murmur during a regular check-up, they may arrange for you to have one or more follow-up tests to help identify the cause. A murmur is not always a cause for concern. You may have a mild form of heart valve disease or sometimes hearts produce a murmur with no apparent cause. The follow-up tests will determine if you have heart valve disease and how to treat it.
Resources
Initial Consultation Guide
This guide will help you prepare for an appointment with your doctor and support an efficient, informative, and helpful consultation. It outlines the types of questions your doctor may ask you during the consultation, as well as questions you'll want to consider asking.
Shared decision making
People diagnosed with heart valve disease are often confronted with a wide range of treatment options. Shared decision-making involves doctors and patients working together to choose the most suitable treatment, based on the patient’s preferences and goals as well as clinical evidence and the care team’s expertise. These resources aim to support people with heart valve disease in participating in decision-making about their care.
Get the shared-decision making guide
Symptom Tracker
Our symptom tracker has been developed to help people who think they may have heart valve disease, or other cardiac conditions, prior to or during consultation periods with their doctor. It captures symptoms to help you and your doctor understand your health and assist with diagnosis and ongoing care planning.
There is life after treatment.
Each person’s path to recovery will look different. Your treatment plan will be unique to your needs, and likewise, your recovery — the time it takes to return to a normal activity level and adapt to lifestyle changes — may vary from what others experience. Taking time to recover, both physically and mentally, is an important part of your journey.