Mitral Valve Regurgitation


The mitral valve lets blood flow from the upper to lower areas of the heart. Mitral valve regurgitation occurs when the valve can't close all the way and blood backs up into the upper area of the heart. This causes the heart to work harder to pump the extra blood.

You may have this condition for many years without having problems. But over time, it can weaken the heart and lead to heart failure.

This condition can be caused by many things, including calcium buildup on the valve and other health problems such as coronary artery disease or rheumatoid arthritis.

Your doctor may just want to watch your health closely if you have mild mitral valve regurgitation. You may take medicine to treat a problem that is causing the regurgitation. Or you may take medicine for other health problems that are caused by this condition. You may need surgery to repair or replace the valve.


Mitral valve regurgitation

Location of mitral valve in the heart and detail of mitral valve regurgitation

Mitral valve regurgitation happens when the mitral valve does not close tightly enough after blood flows through the valve into the lower chamber of the heart. This makes a small opening in the valve even when the valve is closed. This opening can let blood leak (regurgitate) back into the upper chamber of the heart.

What are the symptoms of mitral valve regurgitation?

Symptoms of chronic mitral valve regurgitation may take decades to appear. They include being tired or short of breath when you are active.

Because you may not have symptoms, a specific type of heart murmur might be the first sign your doctor notices.

If you develop heart failure, you may have other symptoms. They include:

  • Shortness of breath with activity. This can later develop into shortness of breath at rest and at night.
  • Tiredness and weakness.
  • A buildup of fluid in the legs and feet. This buildup is called edema.

Acute mitral valve regurgitation is an emergency. Symptoms come on quickly. They include severe shortness of breath, fast heart rate, lightheadedness, weakness, confusion, and chest pain.


What causes mitral valve regurgitation?

Primary mitral valve regurgitation may be caused by problems like mitral valve prolapse or calcium buildup on the mitral valve. Secondary regurgitation may be caused by coronary artery disease or heart failure. Acute regurgitation is caused by a problem that happens all of a sudden, such as a heart attack.


How is mitral valve regurgitation diagnosed?

When your doctor suspects that you have mitral valve regurgitation, you will be asked about your past health and have a physical exam.

To diagnose the problem and check your heart, you'll likely have an echocardiogram.

Your doctor may also order tests to check your heart. These tests may include an electrocardiogram, MRI, and cardiac catheterization.


How is mitral valve regurgitation treated?

Treatment for chronic mitral valve regurgitation includes regular tests to check how well the valve and the heart are working. You may take medicine to treat problems caused by the regurgitation. Or you may take medicine to treat a heart problem that's causing it. Your doctor will likely recommend a heart-healthy lifestyle.

If your condition becomes severe, you may choose to have the valve repaired or replaced. You and your doctor can talk about a few things to decide. These things include the cause of the regurgitation, the anatomy of the valve, if you have symptoms, how well your heart is pumping blood, and your feelings about having surgery or a procedure.

Treatment for acute mitral valve regurgitation occurs while you are in the hospital or the emergency room. You need surgery right away to repair or replace the valve.

When to Call

Mitral valve regurgitation: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have severe trouble breathing.
  • You cough up pink, foamy mucus.
  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.
    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

Call your doctor now or seek immediate medical care if:

  • You have new symptoms or your symptoms get worse.
  • You have new or increased shortness of breath.
  • You are dizzy or lightheaded, or you feel like you may faint.
  • You have sudden weight gain, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
  • You have new or increased swelling in your legs, ankles, or feet.
  • You are suddenly so tired or weak that you cannot do your usual activities.

Watch closely for changes in your health, and be sure to contact your doctor if you develop new symptoms.


Caring for yourself when you have mitral valve regurgitation

You can live a full and active life by doing things that help keep your heart and body healthy. Here's how.

  • Have a heart-healthy lifestyle.
    • If you smoke, try to quit. Medicines and counseling can help you quit for good. Avoid secondhand smoke too.
    • Eat heart-healthy foods. These foods include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit things that aren't so good for your heart, like sodium, alcohol, and sugar.
    • Be active but don't start an exercise program on your own without talking with your doctor first. You may need some tests to see what kind and level of exercise is safe for you. Try for at least 30 minutes of activity on most days of the week. If activity is not likely to cause health problems, you probably don't have limits on the type or level of activity that you can do. If your condition is severe, your doctor will likely advise you to avoid strenuous activity.
    • Stay at a healthy weight. Lose weight if you need to.
    • Manage other health problems. These include diabetes, high blood pressure, and high cholesterol. If you think you may have a problem with alcohol or drug use, talk to your doctor.
  • Take care of yourself.
    • Call your doctor right away if you have new symptoms or symptoms that get worse.
    • Go to your checkup appointments. And get the tests you need to assess your heart, such as echocardiograms.
    • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
    • Practice good dental hygiene, and have regular checkups. Good dental health is especially important. That's because bacteria can spread from teeth and gums to the heart valves.
    • Get a flu vaccine every year. And get a pneumococcal vaccine. If you've had one before, ask your doctor if you need another dose. Stay up to date on your COVID-19 vaccines.
    • Talk with your doctor if you have concerns about sex and your heart. Your doctor can help you know if or when it's okay for you to have sex.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.