• Mitral Regurgitation

    (Mitral Insufficiency)


    The flow of blood pumped by the heart is controlled by one-way valves. These valves assure that blood moves in only one direction. When the heart's mitral valve leaks blood into the upper chamber from the lower chamber, it is called mitral regurgitation.
    If the amount of blood that leaks is severe, mitral regurgitation can be serious. The sooner it is treated, the better the outcome.
    Mitral Valve Regurgitation
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    Mitral regurgitation may be caused by:
    • Mitral valve prolapse—Abnormal closure of the valve with protrusion of a leaflet tip backward into the left atrium, causing it to leak.
    • Infections that cause scarring of the heart valve such as rheumatic fever or bacterial endocarditis.
    • Damage from a heart attack.
    • Several different types of congenital heart defects, which can affect mitral valve function.
    • Cardiomyopathies—Diseases that weaken the heart muscle and stretch the mitral valve.

    Risk Factors

    Factors that may increase your chance of developing mitral regurgitation include:


    The speed with which symptoms progress closely follows the cause of mitral disease. Acute diseases cause rapid decline, while more chronic diseases lead to slower onset of symptoms.
    Mitral regurgitation may cause:
    • Chronic, progressive fatigue
    • Shortness of breath, especially with exertion
    • Worsening shortness of breath when you lie down
    • New, associated palpitations or racing heart rate, which may suggest the development of a heart arrhythmia


    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Leaking heart valves usually make sounds called murmurs that can be heard through a stethoscope. You will likely be referred to a cardiologist.
    Imaging tests evaluate the heart and surrounding structures. These can be done with:
    An ECG can measure your heart's electrical activity.


    Treatment options depend on the severity and history of the valve leakage and its effects on the heart’s size and function. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

    Treat Underlying Disease

    Correcting the underlying problem may help the mitral valve function. The treatment depends on the symptoms. In chronic and slowly progressive mitral regurgitation, medications may help reverse effects on the heart’s size. Ultimately, surgery will likely be needed. In acute and rapidly declining disease, the benefit of medications is limited to short term stabilization until emergency surgery occurs.


    There are several open heart surgical procedures that can fix leaking valves. The type chosen will depend on the valve and the expert recommendation of the surgeon. The valve may be repaired, if it is an option, or it will be replaced.


    To help reduce the chances mitral regurgitation:
    • Prevent cardiovascular disease by controlling weight and blood pressure, exercising, eating heart-healthy foods, and watching your cholesterol levels
    • Avoid contact with streptococcal diseases including strep throat, pharyngitis, and scarlet fever
    • Get prompt treatment for infections
    • Avoid IV drug use
    • Limit alcohol intake


    American Heart Association http://www.heart.org

    National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov


    Canadian Cardiovascular Society http://www.ccs.ca

    Heart and Stroke Foundation of Canada http://www.heartandstroke.ca


    Mitral regurgitation. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115306/Mitral-regurgitation. Updated June 5, 2017. Accessed September 14, 2017.

    Mitral valve regurgitation. CardioSmart—American College of Cardiology website. Available at: https://www.cardiosmart.org/Heart-Conditions/Mitral-Valve-Regurgitation. Accessed September 14, 2017.

    Problem: Mitral valve regurgitation. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Problem-Mitral-Valve-Regurgitation%5FUCM%5F450612%5FArticle.jsp#.WbruHbKGNxA. Updated September 7, 2017. Accessed September 14, 2017.

    Shipton B and Wahba H. Valvular heart disease: review and update. Am Fam Physician. 2001;63(11):2201-2208.

    Revision Information

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