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Mitral valve regurgitation is the most common heart valve problem.

Mitral leaking results from the mitral valve failing to close properly, with some of the blood that’s meant for the heart’s left ventricle instead pooling in the left atrium.

There are two types of mitral valve regurgitation:

  • Functional: Other heart problems cause the heart's lower left chamber (ventricle) to swell. That interferes with the valve's frame (annulus) and/or its flaps (leaflets), which are otherwise intact. Functional regurgitation is also called secondary regurgitation.
  • Degenerative: Also called floppy valve syndrome, degenerative mitral valve (DMV) disease involves structural changes to the valve's flaps (leaflets), frame (annulus) and/or tissue strings (chordae) holding it in place. This weakens the valve.

When the condition is minor, it may not require treatment. But intervention is often necessary when the heart is straining to replace the trapped blood and keep up with demand.

Mitral Valve Regurgitation Causes

There are several potential causes of degenerative mitral valve (DMV) disease:

  • Mitral valve prolapse (MVP): Prolapse is the most common cause of degenerative disease, though in many cases it is harmless. Some types are marked by excess valve tissue and others by thinning tissue. While the reasons for the changes are not always known, it appears there is a connection to aging or inherited genes. Associated names include:
    • Barlow’s disease
    • Fibroelastic deficiency
    • Billowing mitral valve
    • Click-murmur syndrome
  • Weakened heart muscle: from a previous heart attack
  • Rheumatic fever from untreated strep throat
  • Rare genetic disorders such as Marfan syndrome
  • Congenital heart defects
  • Coronary artery disease
  • High blood pressure 
  • Valve infections 

Mitral Valve Regurgitation Symptoms

Mild regurgitation causes no symptoms until it worsens, and they can develop gradually or suddenly. The sudden appearance is often connected to a heart attack, infection or the rupture of connecting cords between muscles and the valve.

Symptoms include:

  • Fatigue, exhaustion and light-headedness
  • Feeling that the heart is beating too hard, too fast, skipping a beat or fluttering (palpitations)
  • Shortness of breath that worsens with activity or when lying down
  • Rapid breathing (especially when lying on the left side in the case of mitral valve regurgitation)
  • Swelling of the feet, legs or abdomen
  • Cough
  • Excessive nighttime urination

Mitral Valve Regurgitation Treatment

Treatment for valve regurgitation depends on your symptoms, the cause of the regurgitation, the impact on your heart's function and whether steps are needed to protect it from further damage. 

Patients with mild regurgitation may only need regular checkups or medications. These medications may include: 

  • Ace inhibitor: relaxes blood vessels and lowers blood pressure
  • Diuretic (water pill): removes fluid in the lungs, tissue and blood, lessening the heart's workload
  • Beta-blocker: helps the heart beat slower, reducing the strain
  • Anti-coagulant (blood thinner): reduces the risk of faulty valves forming blood clots, which can cause a stroke
  • Anti-arrhythmic medication: restores normal heart rhythm

More severe regurgitation usually requires surgery. Learn more about mitral valve repair. 

 

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