Treatments For Mitral Valve Regurgitation

September 23, 2023

Mitral valve regurgitation is a cardiac problem characterized by a leaky mitral valve that does not close as it should. Also known as mitral insufficiency, this condition causes blood to leak into the cardiac muscle rather than flowing out into the rest of the body. Symptoms of mitral valve regurgitation include rapid heart rate or palpitations, fatigue, shortness of breath, and lightheadedness. Palpitations usually become more severe when the patient is lying down on their left side. In some individuals, mitral valve insufficiency may not produce any symptoms and may be detected incidentally during an exam for another condition. Doctors will take the patient's health history and perform a physical examination when attempting to diagnose mitral valve regurgitation.

Patients will be asked about their overall health and cardiac health as well as issues such as a family history of heart disease. Vital signs such as height, weight, and blood pressure will be measured. The doctor will begin by listening to the patient's heart with a stethoscope and will listen for abnormal heart sounds and heart murmurs that may suggest mitral valve insufficiency. If a problem is detected, patients will be referred to a cardiologist for additional tests. Tests typically carried out at the cardiologist include an electrocardiogram, an echocardiogram, a chest x-ray, and a cardiac MRI. The treatments outlined below are often used for mitral valve regurgitation now.

Mitral Valve Repair Surgery

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Mitral valve repair surgery is just one of several surgical options that may be recommended for severe cases of mitral valve regurgitation. The surgery is done under general anesthesia and typically takes between two to four hours. Surgeons can use minimally invasive methods to reduce bleeding and post-operative recovery time. During the procedure, surgeons may use robotic devices as well. Mitral valves can be repaired in a variety of ways, and patients will have pre-surgery scans and other tests so surgeons can determine the most effective way of treating the patient's particular mitral problem. Examples of repair techniques include triangular resection and the use of a special cord for chordal repair.

Mitral Valve Replacement Surgery

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While most patients who need surgery for mitral valve regurgitation will start with a mitral valve repair surgery, these are not suitable for all cases. In some instances, mitral valve repairs may fail over time, and it may be that a patient's condition is too severe for a repair to be advisable. For these patients, mitral valve replacement surgery may be appropriate, and the operation is performed under general anesthesia. In this procedure, the mitral valve is removed and replaced with an artificial one. Artificial valves may be made with valves from cows or pigs, and artificial valve replacements are also available. Replacements are sometimes obtained from organ donation. After having this operation, patients will need approximately four to eight weeks of recovery time.

Consuming A Heart-Healthy Diet

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Consuming a heart-healthy diet can help mitral valve regurgitation patients reduce the elevated blood pressure that may occur as a result of the condition. For some patients, dietary changes may also reduce fatigue and enable them to use fewer medications. A heart-healthy diet is generally based on fruits, vegetables, legumes, and whole grains. Diets such as the DASH, vegan, and Meditteranean diets have shown promise in symptom management of heart conditions. In particular, cardiac patients may wish to limit their intake of processed and cured meats like bacon and salami. It is useful to eliminate fast food from the diet and also minimize fried foods such as french fries and fried chicken when attempting to avoid trans fats. Patients should also be mindful of their sugar intake and try to aim for the American Heart Association's recommendation of no more than twenty-four grams of added sugar each day.

Heart Medication

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Heart medication is often the first line of treatment for mitral valve regurgitation, and it is a particularly important treatment for patients who are not suitable candidates for surgery. Doctors frequently prescribe diuretics to reduce the buildup of fluid in the lungs and lower limbs that can occur with this condition. These drugs cause the body to release larger than normal quantities of salt and water through urination. Diuretics may cause side effects such as increased thirst, headaches, dizziness, diarrhea, increased cholesterol, and muscle cramps. For patients who have both mitral valve regurgitation and atrial fibrillation, doctors may also prescribe anticoagulants (blood thinners), which reduce the risk of developing dangerous blood clots. Patients taking certain blood thinners may need to have frequent blood tests for monitoring. Potential side effects of anticoagulants can include feeling cold and bruising or bleeding more easily after minor injuries.

Keep Blood Pressure Under Control

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A blood pressure reading of higher than 120/80 is considered high. Having high blood pressure can worsen mitral valve regurgitation, and patients are advised to keep blood pressure under control. To do this, doctors recommend eating a healthy diet low in fast foods, fried foods, processed foods, and sodium. If lifestyle changes are not sufficient to keep blood pressure in a normal range, doctors may prescribe beta blockers to reduce elevated pressure. Beta blockers work by opening blood vessels to achieve better blood flow, and they also block a hormone known as adrenaline that raises blood pressure. Patients taking these medications may experience weight gain, fatigue, cold hands and feet, depression, insomnia, and shortness of breath. If side effects are bothersome, patients may be able to switch to an alternate medication. While taking beta blockers, patients will have their blood pressure monitored at regular clinic appointments, and they may also be instructed to take blood pressure readings at home.

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