The mitral valve is on the left side of the heart. It lets blood flow from the upper to the lower heart chamber. Mitral valve regurgitation is diagnosed when the mitral valve in the heart does not close well, which causes blood to leak back from the left ventricle into the left atrium. Mitral valve regurgitation forces the heart to work harder to pump extra blood out of the heart.
Causes and Types of Mitral Valve Regurgitation
There are two forms of mitral valve regurgitation:
- Chronic mitral valve regurgitation: This is the most common type of mitral valve regurgitation and develops slowly. Many children with this problem may have a valve that is more susceptible to wear and tear. As the child gets older, the valve gets weak and no longer closes tightly. Other causes include heart failure, rheumatic fever, congenital heart disease, a calcium buildup in the valve, and other heart problems.
- Acute mitral valve regurgitation: This type of mitral valve regurgitation develops quickly and can be life-threatening. Ususally there is a nearby tissue or the valve itself ruptures. Instead of a slow leak, blood builds up quickly in the left side of the heart. The heart does not have time to adjust to this sudden buildup of blood the way it does with the slow buildup of blood in chronic regurgitation. Common causes of acute regurgitation are heart attack and a heart infection called endocarditis.
Symptoms of Mitral Valve Regurgitation
Children with mild to moderate regurgitation usually do not develop any symptoms. However, children with more severe leakage or regurgitation may experience symptoms such as:
- Shortness of breath
- Difficulty breathing, especially during exertion
- Rapid breathing
- Poor feeding
- Delayed growth
- Excessive sweating
- Fast heart rate
- Heart failure
The doctor may hear a specific type of heart murmur as the first sign of mitral valve regurgitation. Further tests may be needed to check the heart which may include echocardiogram, electrocardiogram, chest X-ray, or cardiac catheterization.
Diagnosis of Mitral Valve Regurgitation
Mitral regurgitation may be identified during routine an echocardiogram. In most cases with very mild leakage, the finding is not significant.
In milder forms of mitral regurgitation, the electrocardiogram and chest X-ray may be completely normal. The echocardiogram is very useful, as it will help classify mitral regurgitation into mild-moderate or severe leakage. An echo also helps determine the size of the left heart as well as its function (contractility). In many instances, it may also help determine the possible etiology (cause) of the leakage.
Mitral Valve Regurgitation Treatment
Depending on the severity of the leakage in the heart, mitral valve regurgitation may be treated with medicine that helps the left ventricle pump better so less blood leaks back into the left atrium. If medicine does not help, your child may need surgery to repair or replace their mitral valve.
Mitral valve regurgitation may lead to an arrhythmia. If this happens, your child may need medicines that help control their heartbeat.