Summary about Disease
Mitral regurgitation (MR), also known as mitral insufficiency or mitral incompetence, is a heart valve disorder in which the mitral valve doesn't close properly, allowing blood to leak backward into the left atrium when the left ventricle contracts. This reduces the amount of blood that is pumped forward to the body and can lead to various heart problems. The severity can range from mild, often causing no symptoms, to severe, requiring intervention.
Symptoms
Symptoms can vary depending on the severity of the regurgitation. Mild MR may not cause any symptoms. More severe MR can cause:
Shortness of breath, especially with exertion or when lying down
Fatigue
Lightheadedness or dizziness
Cough
Heart palpitations (feeling of rapid, fluttering, or pounding heartbeat)
Swollen ankles and feet
Increased urination at night
Causes
Mitral regurgitation can be caused by various factors, including:
Mitral Valve Prolapse: The leaflets of the mitral valve bulge back into the left atrium during ventricular contraction.
Rheumatic Fever: A complication of strep throat that can damage the mitral valve.
Endocarditis: An infection of the heart valves.
Coronary Artery Disease: Can cause damage to the papillary muscles, which support the mitral valve.
Cardiomyopathy: Enlargement and weakening of the heart muscle can distort the mitral valve.
Congenital Heart Defects: Some people are born with abnormalities of the mitral valve.
Calcification: Calcium deposits on the valve can cause it to stiffen and not close properly.
Medications or Radiation: Certain medications and radiation therapy to the chest can damage the mitral valve.
Medicine Used
Medications for mitral regurgitation aim to manage symptoms and prevent complications. They do not repair the valve. Common medications include:
Diuretics (Water Pills): To reduce fluid buildup in the lungs and body. Examples: Furosemide, Spironolactone.
ACE Inhibitors or ARBs: To lower blood pressure and reduce the workload on the heart. Examples: Lisinopril, Valsartan.
Beta-Blockers: To slow the heart rate and lower blood pressure. Examples: Metoprolol, Atenolol.
Anticoagulants (Blood Thinners): To prevent blood clots if atrial fibrillation is present. Examples: Warfarin, Apixaban.
Antiarrhythmics: To control irregular heart rhythms. Examples: Digoxin, Amiodarone.
Antibiotics: Preventative antibiotics may be used before dental procedures to avoid endocarditis if there is valve damage.
Is Communicable
Mitral regurgitation itself is not communicable. It is not caused by an infectious agent and cannot be spread from person to person. However, if the MR is caused by endocarditis, the infection that caused the endocarditis could potentially be communicable, but the MR is a result of that infection, not communicable by itself.
Precautions
Precautions for individuals with mitral regurgitation depend on the severity of the condition. General precautions include:
Regular Medical Checkups: Follow up with a cardiologist for monitoring.
Healthy Lifestyle: Maintain a healthy weight, eat a balanced diet, and exercise regularly as directed by your doctor.
Avoid Smoking: Smoking can worsen heart conditions.
Manage Blood Pressure: Control high blood pressure.
Prevent Endocarditis: Good dental hygiene and preventative antibiotics before certain procedures may be recommended.
Medication Adherence: Take prescribed medications as directed.
Low Sodium Diet: Reduce salt intake to help control fluid retention.
Fluid Restriction: In some cases, fluid restriction may be recommended.
How long does an outbreak last?
Mitral regurgitation is a chronic condition, not an outbreak. If mitral regurgitation is caused by acute endocarditis, it requires prompt antibiotic therapy. A person typically will take antibiotics for 4–6 weeks to clear the infection.
How is it diagnosed?
Mitral regurgitation is typically diagnosed through:
Physical Exam: Listening to the heart with a stethoscope may reveal a heart murmur.
Echocardiogram: Ultrasound of the heart, which is the primary diagnostic tool, assesses the structure and function of the mitral valve and measures the severity of regurgitation.
Electrocardiogram (ECG/EKG): Records the electrical activity of the heart and can detect arrhythmias or signs of heart enlargement.
Chest X-Ray: Can show enlargement of the heart or fluid buildup in the lungs.
Cardiac MRI: Can provide more detailed images of the heart and mitral valve.
Cardiac Catheterization: Rarely needed, but can assess the pressures in the heart and pulmonary artery.
Timeline of Symptoms
The timeline of symptoms can vary greatly:
Mild MR: May have no symptoms for many years.
Moderate MR: Symptoms may develop gradually over time, such as fatigue or shortness of breath with exertion.
Severe MR: Symptoms can develop more rapidly and be more severe, including significant shortness of breath, fatigue, and swelling.
Acute MR: If mitral regurgitation develops suddenly (e.g., due to a ruptured chordae tendineae), symptoms can be severe and require immediate medical attention.
Important Considerations
Regular monitoring is crucial: Even if asymptomatic, regular check-ups and echocardiograms are needed to monitor the progression of the condition.
Timing of intervention: Surgical repair or replacement of the mitral valve is often recommended when symptoms worsen or when the heart begins to enlarge, even if symptoms are mild.
Individualized treatment: The best approach to managing mitral regurgitation depends on the cause, severity, symptoms, and overall health of the individual.
Consult a cardiologist: It is essential to seek care from a qualified cardiologist who can provide accurate diagnosis, treatment recommendations, and ongoing management.