Rachel obtained a Bachelor of Science in Biology from Grove City College. She then earned her Bachelor's and Master's Degree in Nursing from Thomas Jefferson University. For over 8 years, Rachel has practiced as a Board Certified Family Nurse Practitioner, and taught science to elementary aged students.
What Is Mitral Regurgitation?
Have you ever driven in the center of a city? The roads are narrow and there are one-way signs plastered everywhere. These one-way signs can be particularly frustrating, especially when you really want to turn the opposite direction of the sign. However, the signs serve a purpose. They help to maintain the flow of traffic. If narrow streets where only one car can pass were not labeled as one-way, can you imagine the mess? Say it with me - gridlock! Well, our hearts - the center of our circulatory system - is a one-way kind of place.
The heart is composed of four rooms, or chambers. Separating the chambers from one another and from the rest of the body are four doors, or valves. The two chambers on the left side of the heart are (atrium on top, ventricle on bottom) divided by the mitral valve. The mitral valve's job is as follows: the atrium squeezes blood into the ventricle, at the end of the squeeze it is the mitral valve's job to shut the door, keeping all of the blood in the ventricle. Then in turn, the left ventricle squeezes the blood out through the aorta and to the rest of the body.
So what exactly is mitral valve regurgitation? Well, mitral valve regurgitation is when the mitral valve fails to completely close the door so to speak, allowing blood to flow BACK into the atrium. As you can imagine, just like in the crowded city center, this failure to follow the one-way flow can lead to major problems.
Symptoms of Mitral Regurgitation
Believe it or not, many patients with mitral regurgitation have no symptoms at first. And when the symptoms do begin, they occur gradually.
The first symptom (of which patients are unaware) is a heart murmur. That blood flowing BACKWARDS from the left ventricle into the left atrium makes a distinctive swishing sound. It is sometimes this heart murmur that healthcare providers notice first, on routine physicals, before the patient even has symptoms, which leads to a diagnosis.
As mitral regurgitation continues or worsens, patients will usually notice the following symptoms:
- Shortness of breath, especially following exercise OR when laying down flat
- Heart palpitations, it feels as the heart is pumping extra hard and/or missing a beat
- Lightheadedness and/or fatigue
- Swelling of the lower legs, ankles and feet
Treatment for Mitral Regurgitation
If symptoms are non-existent or mild, or a patient has other more pressing health issues, a healthcare provider may recommend 'watchful waiting'. Routine check-ups would be instituted, but medications and/or surgery would be postponed.
If there is a treatable contributing factor to the mitral regurgitation, such as high blood pressure, an irregular heartbeat or heart failure, then medications may be used to correct these conditions. Beta-blockers, ACE inhibitors, calcium channel blockers, anti-arrhythmics and diuretics are all examples of medications which may be used.
Also, blood-thinners are often used in the management of mitral regurgitation. With the blood flowing in the wrong direction inside the heart organ, it is easy for clots to form. These clots are especially dangerous, leading to heart attacks, stroke, or other major complications. Blood-thinners help prevent these clots from forming.
Depending on the patient's health or the severity of symptoms, surgical correction of the mitral valve may be recommended. With surgery, patients usually have two options: mitral valve repair or mitral valve replacement. Sometimes with a little tweaking, surgeons are able to repair the patient's own mitral valve so it shuts completely with each heartbeat. Other times, the patient's own valve is too compromised and a replacement valve (that of a pig or an organ donor) is used instead.
Mitral regurgitation is when the mitral valve in the heart fails to close all the way, causing blood to flow in the wrong direction from the left ventricle back into the left atrium. In some patients, this may produce no noticeable symptoms at first. However, if the patient were to use a stethoscope and listen to the heart, they would hear a heart murmur. Later, as the condition progresses, patients may notice shortness of breath with activity or when laying flat, heart palpitations, lightheadedness, swelling of the ankles and feet, or coughing. The only cure for mitral valve regurgitation is surgery. But certain patients can effectively manage the condition with medications or with watchful waiting. All patients will need routine follow-up care to make sure this condition is well under control, and that the blood in the heart is obeying the established flow pattern!
Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice.
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