Signs and Symptoms of Mitral Regurgitation
In patients with mitral regurgitation, the lungs become congested with fluid. As fluid accumulates in the lungs, it interferes with the absorption of oxygen from the lungs into the bloodstream. This leads to shortness of breath. Some patients feel short of breath when they exercise or exert themselves. Some patients feel short of breath when they lie down at night. They may need to sleep with their heads elevated to avoid waking up in the middle of the night feeling short of breath.
As the heart dilates (enlarges) and, eventually, decompensates, other symptoms of heart failure develop. Patients may fatigue easily and feel weak; others may also notice swelling in their ankles and feet due to accumulation of fluid in these areas.
Mitral Regurgitation Diagnosis
Using a stethoscope, a physician often diagnoses mitral regurgitation by a characteristic "whooshing" sound (heart murmur) in the chest. Heart murmur is caused by the turbulent flow of blood from the left ventricle across the mitral valve and back into the left atrium. Sometimes a heart murmur is detected incidentally during a routine examination. In many cases, it is found when a patient seeks a doctor's evaluation for shortness of breath symptoms.
Patients with suspected mitral regurgitation undergo an echocardiogram (cardiac echo). The echocardiogram uses sound waves to image the mitral valve and the chambers of the heart. It can also be used to image and assess the amount of blood regurgitating from the left ventricle back into the left atrium. The echocardiogram is also used to assess the efficiency of the pumping function of the left ventricle and to assess whether or not the left ventricle has begun to dilate.
Following a physical examination and cardiac echo, uncertainty about the causes for mitral regurgitation may require that a patient be referred for a cardiac catheterization. During cardiac catheterization, pictures (ventriculograms) are taken to see how well the left ventricle is pumping blood into the aorta and to see the amount of blood that regurgitates across the leaky mitral valve back into the left atrium. The amount of mitral regurgitation is then semiquantitatively assessed and is usually rated as "mild," "moderate," or "severe." During the cardiac catheterization, pictures of the coronary arteries also are obtained to find out if there are partial or total blockages of one or more of the coronary arteries. Blockages may lead to dysfunction of the mitral valve and to mitral regurgitation.