Understanding Mitral Regurgitation
A comprehensive guide to help you understand mitral valve regurgitation, why it matters, and the innovative treatments that can help.
What is Mitral Regurgitation?
Mitral regurgitation (MR), also called mitral insufficiency or a "leaky mitral valve," occurs when the mitral valve doesn't close tightly enough. This allows blood to flow backward in your heart when it should only flow forward.
The mitral valve acts like a one-way door between the left atrium (upper chamber) and left ventricle (lower chamber) of your heart. With each heartbeat, the valve opens to let blood flow from the atrium to the ventricle, then closes to prevent backflow. When the valve doesn't close properly, some blood leaks backward with each heartbeat.
Over time, this backward flow forces your heart to work harder, which can lead to heart enlargement, weakening, and eventually heart failure if left untreated.
Types of Mitral Regurgitation
Primary (Degenerative) MR
The problem is with the valve itself:
- • Mitral valve prolapse (floppy valve)
- • Torn or stretched valve cords (chordae)
- • Calcification of the valve
- • Rheumatic heart disease
- • Infective endocarditis
Secondary (Functional) MR
The valve itself is normal, but:
- • The heart has enlarged (dilated cardiomyopathy)
- • Previous heart attack damaged the muscle
- • Heart failure has stretched the valve opening
- • The leaflets can't meet properly
Symptoms of Mitral Regurgitation
MR often develops gradually, and you may not notice symptoms for years. When symptoms appear, they may include:
Shortness of Breath
Especially during activity or when lying flat at night
Fatigue
Feeling tired even with normal activities
Heart Palpitations
Awareness of your heartbeat, feeling it racing or fluttering
Swollen Feet/Ankles
Fluid buildup due to heart strain
Cough
Especially when lying down, sometimes with pink-tinged mucus
Reduced Exercise Tolerance
Unable to do activities you once did easily
Note: Symptoms often don't appear until MR becomes severe. Regular check-ups are important if you've been diagnosed with a heart murmur or valve abnormality.
Grades of Mitral Regurgitation
MR severity is determined by echocardiography and helps guide treatment decisions:
Trace/Mild MR
Minimal backward flow. Usually doesn't cause symptoms or require treatment beyond monitoring.
Moderate MR
More significant leakage. May cause symptoms and requires closer monitoring. Some patients may need treatment.
Moderate-Severe MR
Substantial backward flow causing the heart to work harder. Treatment is often considered.
Severe MR
Large amount of blood flowing backward. Usually causes symptoms and typically requires treatment.
Treatment Options
Medical Management
For mild to moderate MR or to stabilize symptoms before a procedure:
- • Diuretics: Reduce fluid buildup
- • ACE inhibitors/ARBs: Reduce the heart's workload
- • Beta-blockers: Control heart rate and protect heart function
- • Blood thinners: If atrial fibrillation develops
Note: Medications can help manage symptoms but cannot fix the valve.
MitraClip — Transcatheter Valve Repair
A revolutionary minimally invasive option for patients with significant MR:
- A small clip is attached to the valve leaflets to help them close better
- Performed through a small puncture in the leg — no chest incision
- Ideal for high-risk patients who cannot undergo open-heart surgery
- Hospital stay typically 1-3 days with quick recovery
Surgical Options
Traditional surgical approaches include:
- Mitral Valve Repair: Preferred when possible — the surgeon fixes the existing valve
- Mitral Valve Replacement: The damaged valve is replaced with a mechanical or biological valve
Surgery may be recommended for younger, healthier patients or when valve anatomy isn't suitable for MitraClip.
What to Expect After Treatment
Most patients experience significant improvement after MR treatment:
Did You Know?
- 📊MR is the most common valve problem requiring treatment
- 🫀About 4 million Americans have moderate to severe MR
- ✨MitraClip has been used in over 100,000 patients worldwide
Concerned About Your Valve?
Dr. Bleszynski can evaluate your mitral valve and discuss whether MitraClip or other treatments may help you.
Schedule Evaluation(702) 805-5678