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Complications
By Mayo Clinic staffWhen it's mild, mitral valve regurgitation may never cause problems. But when it's severe, mitral valve regurgitation may lead to these complications:
- Heart failure. In heart failure, your heart is unable to pump enough blood to meet your body's needs. Severe mitral regurgitation places an extra strain on the heart due to the need to pump extra blood. The left ventricle gets bigger and, if untreated, weakens. This can cause heart failure. Fluid and pressure build up in your lungs as a result of mitral valve regurgitation and can eventually put a strain on the right side of your heart, leading to ankle swelling (edema). People with heart failure experience shortness of breath and fatigue and may wake up at night feeling short of breath.
- Atrial fibrillation. This is an irregular heart rhythm in which your heart's upper chambers (atria) beat chaotically and rapidly. Atrial fibrillation can cause blood clots. These blood clots may break loose from your heart and travel through your bloodstream, often to your brain, causing a stroke. Other irregular heartbeats (heart arrhythmias) also may occur in people with mitral valve regurgitation.
- Endocarditis. Endocarditis is an infection of the inner lining of your heart. Typically the infection involves one of the heart valves, especially if it's already damaged. If the mitral valve is damaged, it's more prone to infection than is a healthy valve. You can develop endocarditis when bacteria from another part of your body spread through the bloodstream and lodge in your heart. Doctors used to recommend that some people with mitral valve regurgitation take antibiotics before certain dental or medical procedures to prevent endocarditis, but antibiotics are no longer considered necessary in most cases for someone with mitral valve regurgitation or mitral valve prolapse.
- Pulmonary hypertension. If you have mitral regurgitation for many years and it's untreated, or treated improperly, you can develop pulmonary hypertension. Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs. In mitral regurgitation, your leaky valve may cause increased pressure in the left atrium, which can eventually cause pulmonary hypertension. Pulmonary hypertension in turn causes increased pressure in your right ventricle and atrium, which can lead to heart failure.
References
- Gaasch WH. Overview of the management of chronic mitral regurgitation. http://www.uptodate.com/home/index.html. Accessed May 19, 2011.
- Otto CM. Etiology, clinical features, and evaluation of chronic mitral regurgitation. http://www.uptodate.com/home/index.html. Accessed May 19, 2011.
- Heart valve disease. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/hvd/hvd_all.html. Accessed May 19, 2011.
- Heart valves. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4598. Accessed May 24, 2011.
- Bonow RO, et al. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2008;118:523.
- Ferri FF. Mitral regurgitation. In: Ferri FF. Ferri's Clinical Advisor 2011. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?sid=1161209007&eid=4-u1.0-B978-0-323-05610-6..00022-6--s29555&isbn=978-0-323-05610-6&uniqId=247741773-5. Accessed May 19, 2011.
- Gaasch WH. Indications for and types of corrective surgery in severe chronic mitral valve regurgitation. http://www.uptodate.com/home/index.html. Accessed July 14, 2009.
- Schmitto JD, et al. Minimally invasive valve surgery. Journal of the American College of Cardiology. 2010;56:455.
- Lehr EJ, et al. Robotic cardiac surgery. Current Opinion in Anesthesiology. 2011;24:77.
- Nishimura RA. ACC/AHA guideline update on valvular heart disease: Focused update on infective endocarditis. Circulation. 2008;118:887.
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