Mitral Regurgitation

Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, allowing blood to flow backward from the left ventricle into the left atrium during systole. This can lead to an increase in volume and pressure in the left atrium, potentially causing symptoms such as shortness of breath, fatigue, and palpitations.

Causes

Mitral regurgitation can be caused by a variety of factors, including:

• Myxomatous degeneration: a condition where the valve tissue becomes weak and floppy
• Rheumatic heart disease: a condition where the valve is damaged due to rheumatic fever
• Endocarditis: an infection of the valve
• Cardiomyopathy: a condition where the heart muscle becomes weakened or stiff
• Trauma: injury to the chest or heart
• Congenital abnormalities: birth defects affecting the mitral valve

Symptoms

The symptoms of mitral regurgitation can vary depending on the severity of the condition. Common symptoms include:

• Shortness of breath (dyspnea)
• Fatigue
• Palpitations or irregular heartbeat
• Chest pain or discomfort
• Swollen legs, ankles, or feet due to fluid buildup

Diagnosis

Mitral regurgitation is typically diagnosed using a combination of physical examination, medical history, and diagnostic tests, including:

• Echocardiogram: an ultrasound test that uses sound waves to create images of the heart and its valves
• Chest X-ray: a test that uses radiation to create images of the heart and lungs
• Electrocardiogram (ECG or EKG): a test that measures the electrical activity of the heart
• Cardiac catheterization: a procedure where a small tube is inserted into an artery in the leg and guided to the heart to measure pressure and take blood samples

Treatment

The treatment for mitral regurgitation depends on the severity of the condition and may include:

• Medications: such as diuretics, beta blockers, and ACE inhibitors to manage symptoms and slow disease progression
• Surgery: to repair or replace the mitral valve, including procedures such as mitral valve annuloplasty or mitral valve replacement
• Minimally invasive procedures: such as transcatheter mitral valve repair (TMVR) or percutaneous mitral valve repair

Complications

If left untreated, mitral regurgitation can lead to complications such as:

• Atrial fibrillation: an irregular heartbeat that can increase the risk of stroke and other heart problems
• Pulmonary hypertension: high blood pressure in the lungs that can lead to shortness of breath and fatigue
• Heart failure: a condition where the heart is unable to pump enough blood to meet the body's needs

Prognosis

The prognosis for mitral regurgitation depends on the severity of the condition, the presence of underlying medical conditions, and the effectiveness of treatment. With proper management and treatment, many people with mitral regurgitation can lead active and normal lives.