Valvular heart disease / Mitral regurgitation

Overview – Mitral regurgitation is a valvular disease with abnormalities in the mitral valve.

The mitral valve is present between the heart’s left upper chamber (left atrium) and the left lower chamber (Left ventricle). The mitral valve does not close tightly because of the abnormality in the valve, allowing blood to flow backward into the left upper chamber with each beat.

The causes of mitral valve regurgitation are mitral valve prolapse; rheumatic heart disease; infective endocarditis (infection of the lining of the heart); trauma; use of certain drugs fenfluramine, benfluorex, ergotamine, bromocriptine, cabergoline; cardiomyopathy, congenital malformations, myocardial infarction (heart attack).



  • Shortness of breath
  • Palpitations
  • Swollen ankles or feet
  • Weakness and fatigue



  • Heart failure – In mitral regurgitation, there is a defective valve due to which the blood is pumped back into the left atrium and less blood is going forward with each beat. This puts an extra strain on the heart and if left untreated weakens the heart causing heart failure.
  • Atrial fibrillation – Atrial fibrillation is a rhythm disorder that occurs because of the stretching and enlargement of the upper chamber. Atrial fibrillation can cause blood clots that can break loose and travel to other parts of the body causing serious problems such as stroke.
  • Pulmonary hypertension – There is increased pressure in the arteries of the lungs due to increased pressure in the left upper chamber of the heart.



  • In a patient who has a medical history, or family history of heart disease, and physical examination reveals a heart murmur suggestive of mitral regurgitation, an echocardiogram is done to confirm the diagnosis.
  • Other tests that may be done are cardiac magnetic resonance imaging, cardiac catheterization, stress testing, electrocardiogram.


Lifestyle management

  • Follow a healthy diet and exercise program as recommended by your doctor. Your doctor will recommend a heart-healthy diet that includes lean proteins, fruits, vegetables, and whole grains. Your diet should be low in saturated fat, trans fat, salt.
  • Maintain a healthy weight.
  • Talk to your doctor about how to control high blood pressure.
  • Do not smoke and cut back on alcohol.
  • Keep all the appointments with your doctor. Your doctor may monitor you closely to check for complications of mitral regurgitation.
  • Talk to your doctor if you have your heart valve replaced and planning to undergo dental procedures. Your doctor may prescribe antibiotics before the procedure to prevent infective endocarditis.
  • If you are planning pregnancy talk to your doctor before getting pregnant about how mitral regurgitation might affect pregnancy. Pregnancy causes the heart to work harder. How well the heart tolerates this extra work depends on the severity of mitral regurgitation.


Medical management

  • The symptoms of mitral regurgitation are treated with medications such as diuretics, blood thinners, antihypertensive medications.
  • Surgery is done to repair or replace the mitral valve. The damaged valve may be removed and replaced by a mechanical valve or a valve made from cow, pig or human heart tissue. Repair is done so that the leaflets can close tightly and prevent the backflow of blood into the left upper chamber.

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