Mitral valve regurgitation is a type of heart disease in which the valve between the left chambers of the heart does not close completely and blood leaks backwards. It is a common problem among heart valve diseases. Mitral regurgitation is a disease that occurs for different reasons, progresses slowly and does not show any symptoms for years. The most common symptoms, which are not specific to the disease, are fatigue and shortness of breath. Mitral regurgitation may develop suddenly in some cases, and this condition is called acute mitral valve regurgitation. Findings in the acute form are rapid and clear. In order to detect this disease, echocardiography test is often applied first and the definitive diagnosis of the disease can be made with this method. Mitral valve insufficiency can be treated with some lifestyle changes, medications, and surgical interventions.
What is Mitral Valve Insufficiency?
The mitral valve is one of the 4 main valves that ensures the correct flow of blood. Each valve opens and closes with each heartbeat. However, if one of the valves does not open and close properly, the blood does not go to the right place and blood flow to the body decreases. If this condition is caused by the mitral valve, it is called mitral valve insufficiency. This condition can be caused by a type of bacteria called group A streptococcus, which causes the disease most people had in childhood. If this disease is not treated or treated incorrectly, this bacterium may lead to failure as a result of the development of an autoimmune reaction in the heart valve in later ages. This condition is also called rheumatic mitral insufficiency. Other most common causes are congenital heart valve failure and heart attack at older ages. Some of the factors that cause mitral valve insufficiency in general are as follows:
- Rheumatic fever
- Having a congenital heart defect
- Having a heart attack
- Cardiomyopathy (diseases involving the heart muscle)
- Endocarditis (infection of the inner lining and valves of the heart)
- Having undergone radiotherapy
Symptoms of Mitral Valve Regurgitation
Symptoms of mitral regurgitation can vary from person to person and can occur in different ways. The most common symptom is shortness of breath. Some people have no symptoms While not mentioned, it may occur with symptoms such as heart palpitations in some people. Some of the common signs and symptoms of mitral valve regurgitation are as follows:
- Arrhythmia
- Fluttering
- Heart murmur (external sound of blood flow from the heart)
- Dyspnea that occurs at rest or does not go away despite rest
- Edema in feet and legs (fluid accumulation)
- Easy fatigue
How is Mitral Valve Insufficiency Diagnosed?
Mitral valve regurgitation can be diagnosed in routine controls in line with the patient's complaints or when they have no complaints. Doctors may hear a mitral regurgitation murmur while listening to the heartbeat with a stethoscope during physical examination and may refer to some tests for a definitive diagnosis. Diagnostic methods frequently used in suspected mitral valve insufficiency are as follows:
- Echocardiography: Echocardiography is sound waves that take pictures of the heart. With this method, the structure of the heart and the condition of the mitral valve can be seen. Echocardiography is the method that definitively diagnoses mitral valve insufficiency.
- Electrocardiogram (ECG): Electrical signals coming from the heart are recorded through wires attached to special pads placed in certain parts of the body. With this method, irregular heartbeat, which may be due to mitral valve insufficiency, can be determined.
- Chest X-ray: The condition of the heart and lungs can be seen with chest X-ray. With this method, heart enlargement or fluid accumulation in the lungs can be detected.
- Cardiac MRI: Detailed image of the heart is examined with cardiac MRI. In mitral valve insufficiency, the condition, size and severity of the left heart chambers can be determined.
- Exercise Tests: With exercise tests, it can be determined how the heart responds to physical activities and whether signs of mitral valve insufficiency occur during the test.
What are the Complications of Heart Valve Failure?
Complications of mitral valve regurgitation depend on the course of the disease. In the case of mild mitral valve regurgitation, patients often have no obvious symptoms. Patients realize the condition for many years. They can live with this ailment without suffering. However, in advanced mitral valve regurgitation, the pressure on the heart increases and the heart works harder to pump blood throughout the body. In this case, the left lower chamber of the heart enlarges and the heart muscle weakens. Possible complications that can be seen in mitral heart valve failure are as follows:
- Atrial Fibrillation: Atrial fibrillation (irregular and rapid heartbeat) occurs due to enlargement of the left upper heart chamber (auricle). This is a heart rhythm disorder originating from the atria. Increased blood coagulation and risk of stroke may also occur due to atrial fibrillation.
- Pulmonary Hypertension: Pulmonary hypertension (high blood pressure of the lung) is a condition in which the pressure of the pulmonary blood vessels increases. As the pressure increases, fluid builds up in the lungs. This may be due to mitral valve insufficiency not being treated for a long time or being treated incorrectly.
- Congestive Heart Failure: As a result of mitral valve failure, the heart works harder than normal to pump enough blood to the body. As a result of high performance, the left lower heart chamber (left ventricle) enlarges and the heart muscles weaken. If this condition is not treated, heart failure may occur.
Treatment of Mitral Valve Insufficiency
After the diagnosis of mitral valve insufficiency is made, a treatment plan suitable for the course of the disease is created. The doctor, in the patient interview; The cause of the disease, the general health status of the patient, the severity of blood reflux and the duration of the disease are evaluated and a treatment is recommended accordingly. The treatment modalities of mitral valve regurgitation are as follows:
- Lifestyle Change: In cases where the disease does not cause any discomfort to people, its progression can be prevented with some lifestyle changes. In this type of minimal mitral regurgitation, your doctor may ask you to stop smoking and alcohol use. He may recommend that you remove salt, sugar, saturated and trans fats from your diet and consume plenty of fresh fruits and vegetables and protein. Lifestyle changes may also include doing regular physical activity. Regular activities are good for heart and lung health.
- Drug Therapy: Drug therapy can be applied in case of moderate mitral valve insufficiency. At this stage, leakage (the amount of blood escaping from the valve) is at a level that can be controlled with drugs. These drugs recommended by the doctor; There may be diuretics (diuretics) for edema in the feet and legs, blood thinners to prevent coagulation, beta-blockers for heartbeat irregularities, hypertension drugs to keep blood pressure stable. It is applied in advanced cases where it cannot be treated with other methods. With surgical intervention, the mitral valve can be repaired or replaced with an artificial valve. The operation can be performed open or closed depending on the condition of the damaged mitral valve.
- Transcatheter Mitral Valve Repair: This method is performed when surgery is not possible. This method can be used in cases where the patient's age and general health pose a risk for surgery. The catheter is inserted through a blood vessel in the leg and advanced towards the heart. With this procedure, the mitral valve can be repaired.
What Should Those With Mitral Valve Insufficiency Pay Attention To?
One of the most important issues to be considered in case of mitral valve insufficiency is the doctor's regular use of the prescribed drugs. In addition to this situation, some painkillers and flu medications have the risk of increasing symptoms, so any medication should not be used without the knowledge of a doctor. Apart from this, there are some other issues that patients with mitral valve insufficiency should pay attention to. Some of these issues are as follows:
- Establishing a Diet: Nutrition program to support the heart health of the patients; It may be necessary to add fruit, vegetables, protein, whole grains, fish and lean meat products, and remove high-carbohydrate foods such as saturated-trans fat, sugar, salt, and pastries.
- Exercise: Regular light exercises, It can be beneficial in protecting heart health and providing weight control. Exercises can be non-tiring activities and light-paced walks. However, you should definitely consult your doctor before making an exercise plan.
- Alcohol and Smoking Limiting Its Use: The use of alcohol and cigarettes can cause weakening of the heart muscles and arrhythmia. For this reason, for good heart health, it may be necessary to stop or limit the use of these substances.
- Staying Away from Stress: A stressful life can trigger heart diseases and adversely affect heart health. You can do yoga, meditation or devote more time to your hobbies to suppress stress factors.
- Not Neglecting Health Checks: If you have mitral valve insufficiency, it is important to have your doctor's checkups at regular intervals, even if you do not have any complaints. cholesterol, sugar, blood pressure, etc. Regular monitoring of the values is necessary both for keeping the disease under control and for drug regulation.
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