Mitral regurgitation occurs when the mitral valve in the heart does not close properly, causing blood to leak back into the left atrium. It can be caused by conditions like mitral valve prolapse, rheumatic fever, or heart attacks. Symptoms include cough, fatigue, shortness of breath, and swelling in the legs. Diagnosis involves listening to the heart for murmurs and getting imaging tests like echocardiograms. Treatment options depend on severity but may include medications to manage symptoms or surgery to repair or replace the mitral valve if symptoms worsen.

1. Mitral Regurgitation
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2. Definition:
In mitral regurgitation
the valve does not
close properly. This
causes blood to leak
back (regurgitate)
into the left atrium
when the left
ventricle contracts.

3. Causes
Possible causes of mitral valve regurgitation
include:
• Mitral valve prolapse
• Rheumatic fever
• Endocarditis
• Hypertrophic cardiomyopathy
• Congenital heart defects
• Heart attack
• Coronary heart disease and high blood pressure

4. Symptoms
Symptoms may begin suddenly if:
• A heart attack damages the muscles around
the mitral valve.
• The cords that attach the muscle to the valve
break.
• An infection of the valve destroys part of the
valve.

5. There are often no symptoms. When symptoms
occur, they often develop gradually, and may
include:
• Cough
• Fatigue, exhaution and light-headedness
• Rapid breathing
• Sensation of feeling the heart beat (palpitations)
or a rapid heartbeat
• Shortness of breath that increases with activity
and when lying down
• Urination, excessive at night.
• Swollen feet and ankles.

6. Systolic murmur of mitral regurgitation
In mitral regurgitation,
blood flows backward
through the mitral valve
into the left atrium
during systole.
This also causes a high-frequency
blowing,
swishing sound during
systole

7. Auscultation of heart may reveal:
Diminished S1 in acute mitral regurgitation.
Wide splitting of S2 as a result of early closure of
aortic valve.
S3 as a result of LV dysfunction or increased
blood flow

8. Exams and Tests
When listening to your heart and lungs, the health care
provider may detect:
• A thrill (vibration) over the heart when feeling the chest
area
• An extra heart sound (S4 gallop)
• A distinctive heart murmur
• Crackles in the lungs (if fluid backs up into the lungs)
• The physical exam may also reveal:
• Ankle and leg swelling
• Enlarged liver
• Bulging neck veins
• Other signs of right-sided heart failure

9. • The following tests may be done to look at the
heart valve structure and function:
• CT scan of the chest
• Endocardiogram (an ultrasound examination
of the heart) - transthoracic or
transesophageal
• Magnetic resonance imaging (MRI)

10. • Medication
• Mild cases may not require any regular medication. If you
develop symptoms or complications, various medicines
may be advised.
• For example:
• Diuretics(water tablets) usually help if you are breathless.
They make the kidneys produce more urine. This gets rid of
excess blood and fluid which may build up in the lungs or
other parts of the body with the back pressure from the
heart.
• Angiotensin-converting Enzyme (ACE) inhibitors are
medicines which help to reduce the amount of work the
heart does and to ease symptoms of heart failure.
• Anti-arrhythmic medication may be needed to control your
heart rate if you develop atrial fibrillation.
• Warfarin (anticogulation) is usually advised if you develop
atrial fibrillation. This helps to prevent blood clots from
forming.

11. You may need surgery to replace or repair valve
if:
Heart function is poor
The heart becomes enlarged (dilated)
Symptoms get worse