If your mitral valve, the valve between the left chambers of your heart, does not seal correctly, blood may flow backward when your heart beats. This is called mitral valve regurgitation (MVR). It can cause shortness of breath and fatigue and in severe cases can lead to heart failure.
At the University of Vermont Medical Center (UVM Medical Center), we offer the full range of life-saving treatment options to repair or replace leaking mitral valves. Our goal is to help you live longer and live better.
Mitral Valve Regurgitation at UVM Medical Center
We will provide you with all the treatment options and support you need for your heart condition.
- Comprehensive cardiac center: We offer the full range of cardiac and vascular services. We have the most sophisticated diagnostic technologies, surgical equipment and facilities in our region, so we can get you the expert care you need. Read more about our full-service heart and vascular department.
- Holistic approach: Every patient is unique. Heart conditions can be complicated and can contribute to or cause additional medical issues. We will assess you fully and treat the causes of your heart condition as well as any secondary conditions.
- Clinical trials: As an academic medical center, we are at the forefront of innovation. If current treatments are not getting you the results you want, we may be able to enroll you in a clinical trial testing a new technique or treatment.
Mitral Valve Regurgitation: What You Need to Know
Like a plumbing system, blood flows from your heart in one direction only. Valves ensure this process by allowing blood to flow forward through them and then closing to prevent blood flowing backward.
If your mitral valve does not seal properly, some blood can leak back from a lower chamber (ventricle) into an upper chamber (atrium). This leakage is called mitral valve regurgitation (MVR).
Primary or Secondary MVR
There are two types of MVR. We diagnose them based on their cause:
- Primary MVR is caused by a physical problem with the valve itself. We treat it by fixing or replacing the defective parts of the valve.
- Secondary MVR is when some other condition causes the valve to leak. For example, if your heart enlarges after a heart attack, the valve may not close fully because of this swelling or rather heart enlargement. We treat secondary MVR by treating the condition that causes it.
The Effects of Primary MVR
A leaky mitral valve can be due to a structural defect, either one you were born with or a defect that developed with age, or it can become damaged through trauma. This is what happens:
- Improper seal: The mitral valve has 2 leaflets. They open when blood flows through them from the left atrium into the left ventricle. When the ventricle contracts to pump blood out into the body, the leaflets normally close tightly. If the flaps do not meet correctly, some blood flows backward. This backward flow is called regurgitation.
- Increased pressure: Blood flowing backward into the atrium can put pressure on your circulatory (blood) system. In the most severe cases, the pressure can build in your lungs and make breathing more difficult.
- Harder work: When there isn't a tight mitral valve seal, your heart has to work harder to pump the same amount of blood around your body. When this happens, it causes the heart muscles to strain and possibly enlarge. The extra effort can sometimes cause permanent damage and heart failure.
- Prolapse: A mitral valve that balloons backward under pressure is called a prolapsed valve. Many people live their whole lives with prolapsed valves and have no symptoms or need for treatment. We treat prolapsed valves only if they begin to affect how the heart pumps or if they lead to severe mitral regurgitation. Learn more about mitral valve prolapse.
Symptoms of Mitral Valve Regurgitation
Mitral Valve regurgitation does not always cause obvious symptoms. If the defective mitral valve does not leak significantly, it may not cause a problem, and you may never experience symptoms. Your doctor may recommend ongoing monitoring to make sure the leak doesn't get worse and affect your heart function.
More serious leaks can increase your chances of heart damage and lead to heart failure. Symptoms of serious leaks may include:
- Shortness of breath: If you cannot climb a flight of stairs without becoming short of breath, it could be a sign that MVR is affecting your lungs and straining your heart. Talk to your cardiologist about treatment options.
- Fatigue: Tiredness and the inability to do normal physical activities without becoming exhausted in another sign that your heart has to work too hard to pump blood. Talk to a cardiologist about your treatment options.
- Palpitations: If you can feel your heart palpitating, especially during or after physical activity, it could be a sign the MVR has progressed to a point where you need treatment.
Diagnosis of MVR
Some people are born with defective mitral valves. Some develop leaky mitral valves through wear and tear with age. Others can damage their valves through trauma such as a heart attack. We diagnose MVR using:
- Physical exam: Your doctor may diagnose MVR based on the sound of your heart. A murmur can indicate a problem with one of your heart valves. Sometimes, you may need a cardiologist to diagnose exactly which valve is causing the murmur.
- Echocardiogram: If your doctor suspects MVR, we will recommend an echocardiogram. This ultrasound imaging technology uses sound waves to create an image of your heart and the blood flowing through it. We can see the blood flowing back into the lower heart chamber and diagnose MVR. Learn more about echocardiography.
Treatments for MVR
MVR is caused by a physical problem with the mitral valve and does not typically respond to medications. However, if the leak is mild and you have no other symptoms, your cardiologist may prescribe medications to reduce blood pressure or help your blood flow more easily.
If the MVR is causing symptoms or could lead to heart failure, surgery is the best option. We have a variety of surgical options, including:
- Repair: Our minimally invasive repair is the first and best option. It maintains the integrity of the valve and in most cases is a permanent repair. Learn more about mitral valve surgery.
- Replacement: If your mitral valve is too severely damaged to repair, our surgeons can replace it with a mechanical valve. Read more about mitral valve surgery.
- MitraClip®: This clip reduces leakage in the valve but does not completely solve the problem. It is the best option for people who cannot undergo surgery.
We treat a comprehensive range of heart and heart-related conditions. We have the most advanced technologies, skilled heart team and best facilities in our region. Some of the conditions we treat include:
- Heart failure: If your heart cannot pump enough blood for your body's needs, it can lead to permanent damage to your heart muscle. Heart failure is often cause by other conditions such as blocked arteries, high blood pressure or MVR. Read more about heart failure.
- Atrial fibrillation: When the atrial chambers of your heart don't beat in synch with each other, it can lead to stroke or heart failure if not treated. Learn more about how we can treat atrial fibrillation.
- Ischemic heart disease: Like all muscles, your heart needs a sufficient supply of blood to keep working. If the supply becomes blocked, it can damage your heart, leading to a heart attack. Learn more about ischemic heart disease.