The mitral valve sits in the left side of the heart. It helps to control the flow of blood from the top part of the heart to the bottom part. The valve makes sure the blood moves in one direction.
Mitral regurgitation is a leak in this valve. Blood leaks back into the upper chamber. Minor leaks may not be noticed. Severe leaks can cause serious symptoms and illness. The sooner it is treated, the better the outcome.
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Mitral regurgitation may be the result of a defective valve such as:
- Mitral valve prolapse—the valve cannot close properly
- Several different types of congenital heart defects, which can affect mitral valve function.
The valve can also be damaged by other conditions such as:
Factors that may increase your chance of developing mitral regurgitation include:
- A history of rheumatic fever or other serious infectious disease
- Autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis
- Storage diseases such as hemochromatosis and glycogen storage disease
- Cardiovascular disease
- Muscle disease
- Alcohol use disorder
- Radiation exposure
- Exposure to certain drugs such as lithium, sulfonamides, chemotherapy, and phenothiazines
Symptoms may appear quickly or slowly over time. Mitral regurgitation can cause:
- Chronic, progressive fatigue
- Shortness of breath, especially with activity
- Shortness of breath gets worse when you lie down
- Feeling of fluttering in chest or racing heart rate
Your doctor will ask about your symptoms and health history. A physical exam will be done. A leaking heart valves will make a sound called a murmur. The doctor may be able to hear it during an exam. You will likely be referred to a cardiologist.
Images of the heart will help to find which valve is damaged. Image options include:
Treatment will be based on how severe the leak is. It will also depend on how it is affecting overall heart health. Severe regurgitation can cause congestion in the lungs. Overtime, it will also cause an enlargement of the heart muscle.
Treatment options include the following:
When possible the underlying cause will be treated. It may allow the valve to work normally again.
Medicine may help decrease symptoms and effects on the heart. It is an option for those with less severe and slow progressing disease.
Medicine may also help to stabilize severe disease for a short time. It may be used to stabilize someone before surgery. A pump may also be needed to help support the heart to be ready for surgery.
Valves that are causing severe problems or getting worse fast will need surgery. The valve will be repaired or replaced.
To help reduce the chances mitral regurgitation:
Follow heart healthy habits such as:
- Control weight and blood pressure
- Exercise regularly
- Eat heart-healthy foods
- Get prompt treatment for infections
- Avoid IV drug use
- Limit alcohol intake
American Heart Association
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
Mitral regurgitation. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/mitral-regurgitation. Accessed September 14, 2019.
Mitral valve regurgitation. CardioSmart—American College of Cardiology website. Available at: https://www.cardiosmart.org/Heart-Conditions/Mitral-Valve-Regurgitation. Accessed September 14, 2019.
Problem: Mitral valve regurgitation. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Problem-Mitral-Valve-Regurgitation_UCM_450612_Article.jsp#.WbruHbKGNxA. Accessed September 14, 2019.
Shipton B and Wahba H. Valvular heart disease: review and update. Am Fam Physician. 2001;63(11):2201-2208.
3/12/2018 DynaMed Plus Systematic Literature Surveillancehttps://www.dynamed.com/condition/mitral-regurgitation: Uretsky S, Argulian E, et al. Use of cardiac magnetic resonance imaging in assessing mitral regurgitation: current evidence. J Am Coll Cardiol. 2018 Feb 6;71(5):547-563.
Last reviewed September 2020 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 8/14/2020