Mitral Valve Insufficiency: Symptoms, Risks, and Management

Q: Mitral Valve Insufficiency: Symptoms, Risks, and Management

Hello： Echocardiography is a highly precise examination. <br>Mild mitral regurgitation detected through ultrasound is quite common in the middle-aged and elderly population; however, most individuals are asymptomatic. <br>Symptoms of moderate to severe mitral regurgitation typica

Incomplete membranous closure

Hello, recently I experienced palpitations and sharp chest pain, so I went to the hospital for a cardiac ultrasound.
The doctor said that I do not have mitral valve prolapse, but there is slight incomplete closure of the mitral valve.
In the past two days, I have also noticed slight numbness in my hands and feet.
Could this be caused by the mitral valve insufficiency? What should I pay attention to with mild mitral valve insufficiency? Is there a possibility that it could progress to moderate or severe insufficiency? Additionally, is mitral valve insufficiency classified as congenital or acquired? (I have never had these symptoms before.) Thank you.

Xiao Chen, 30~39 year old female. Ask Date: 2019/05/30

Dr. Huang Yinghe reply Cardiology

Hello: Echocardiography is a highly precise examination.
Mild mitral regurgitation detected through ultrasound is quite common in the middle-aged and elderly population; however, most individuals are asymptomatic.
Symptoms of moderate to severe mitral regurgitation typically include shortness of breath, chest discomfort, palpitations, or edema.
(Numbness in the limbs is unrelated to valve insufficiency and may be due to anxiety, hyperventilation, or peripheral nerve issues.) The causes of mitral regurgitation include congenital heart defects as well as acquired conditions.
Decades ago, when medical advancements were limited, rheumatic fever often led to valvular heart disease.
Nowadays, it is more commonly associated with hypertensive heart disease, ischemic heart disease, or immune-related disorders.
Therefore, if there are no congenital deficiencies or acquired imbalances, mild mitral regurgitation only requires annual monitoring for any worsening symptoms.
If hypertension is present, it is important to manage blood pressure effectively to prevent deterioration.
For moderate to severe mitral regurgitation, annual echocardiographic follow-up is recommended, and for severe cases, consideration for valve repair or replacement surgery may be necessary.
Wishing you peace, Chiayi Hospital, Dr.
Huang Ying-He.

Reply Date: 2019/05/30

More Info

Mitral valve insufficiency, also known as mitral regurgitation, occurs when the mitral valve does not close tightly, allowing blood to flow backward into the left atrium when the left ventricle contracts. This condition can lead to various symptoms and complications, depending on its severity and the underlying causes.

Symptoms of Mitral Valve Insufficiency
Common symptoms of mitral valve insufficiency can include:
1. Palpitations: You mentioned experiencing heart palpitations, which can occur due to the heart working harder to compensate for the backflow of blood.

2. Chest Pain: The chest pain you described may be related to the increased workload on the heart or could be due to other cardiac or non-cardiac causes.

3. Shortness of Breath: This can occur during exertion or when lying flat, as fluid may accumulate in the lungs due to increased pressure in the left atrium.

4. Fatigue: As the heart struggles to pump effectively, you may feel more fatigued than usual.

5. Numbness or Tingling: The symptoms of hand and foot numbness could be related to anxiety, poor circulation, or other neurological issues, but they are not typical symptoms of mitral valve insufficiency.

Risks and Progression
Mild mitral valve insufficiency may not cause significant problems and can often be monitored without immediate intervention. However, it is essential to have regular follow-ups with your healthcare provider to assess any changes in the condition.
1. Progression: Mild cases can sometimes progress to moderate or severe insufficiency, especially if there are underlying conditions such as hypertension, coronary artery disease, or other heart valve diseases. Regular echocardiograms can help monitor the valve's function and any changes over time.

2. Complications: If left untreated, significant mitral regurgitation can lead to heart failure, atrial fibrillation, or pulmonary hypertension due to the increased pressure in the heart and lungs.

Causes of Mitral Valve Insufficiency
Mitral valve insufficiency can be classified as either congenital (present at birth) or acquired (developing later in life):
1. Congenital Causes: Some individuals may be born with structural abnormalities of the mitral valve, leading to insufficiency.

2. Acquired Causes: More commonly, mitral regurgitation develops due to conditions such as:
- Rheumatic Fever: A complication of untreated strep throat that can damage heart valves.

- Degenerative Changes: Age-related changes or conditions like mitral valve prolapse.

- Ischemic Heart Disease: Damage to the heart muscle from reduced blood flow can affect valve function.

- Infective Endocarditis: Infection of the heart valves can lead to regurgitation.

Management and Monitoring
For mild mitral valve insufficiency, management typically involves:
1. Regular Monitoring: Echocardiograms to assess the severity of the regurgitation and heart function.

2. Symptom Management: Addressing any symptoms you experience, such as palpitations or chest pain, through lifestyle modifications or medications.

3. Lifestyle Changes: Maintaining a heart-healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking, can help manage symptoms and reduce the risk of progression.

4. Medication: If symptoms worsen or if there is significant heart strain, medications such as diuretics or beta-blockers may be prescribed.

In conclusion, while mild mitral valve insufficiency may not be immediately concerning, it is crucial to maintain regular follow-ups with your healthcare provider to monitor your condition. If you experience worsening symptoms or new symptoms arise, such as increased numbness or tingling, it is essential to seek medical advice promptly. Your healthcare provider can provide personalized recommendations based on your specific situation and overall health.

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