Mitral regurgitation - chronic

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Heart, front view

Heart, section through the middle

Chronic mitral regurgitation is a long-term disorder in which the valve (mitral valve) that separates the left upper chamber of the heart (atrium) from the left lower chamber (ventricle) does not close properly. The condition is progressive, which means it gradually gets worse.

Chronic mitral valve regurgitation; Mitral valve insufficiency

Mitral regurgitation is the most common type of heart valve insufficiency. Chronic mitral regurgitation affects approximately 6% of women and 3% of men. After 55 years of age, some degree of mitral regurgitation is found in almost 20% of men and women who have an echocardiogram.

Any disorder that weakens or damages the mitral valve or causes the left ventricle to become widened (dilated) may lead to mitral regurgitation. Over time, more blood backs up into the left atrium from the left ventricle, and the heart has to work harder to pump blood to the rest of the body. This may lead to congestive heart failure.

Mitral regurgitation becomes chronic when the condition persists rather than occurring for only a short time period. Chronic mitral regurgitation should be distinguished from acute mitral regurgitation. Acute mitral regurgitation may become chronic.

Mitral valve prolapse , which involves weakening and ballooning out of the valve and affects about 5% of the population, is a relatively common cause of chronic mitral regurgitation.

About one-third of all cases of chronic mitral regurgitation are caused by rheumatic heart disease, a complication of untreated strep throat that is becoming less common. Rheumatic heart disease can lead to thickening, rigidity, and retraction of the mitral valve leaflets.

Congenital (present from birth) mitral regurgitation is rare if it is not part of a more complex heart defect or syndrome.

Chronic mitral regurgitation can also be caused by disorders such as atherosclerosis , hypertension (high blood pressure), left ventricular enlargement, connective tissue disorders such as Marfan's syndrome , other congenital defects, endocarditis (infection of the heart valve), cardiac tumors, or untreated syphilis (rare). Risk factors include an individual or family history of any of the disorders mentioned above and use of fenfluramine or dexfenfluramine (appetite suppressants now banned by the FDA) for four or more months.

Review Date: 05/30/2006
Reviewed By: Alan Berger, MD, Assistant Professor, Divisions of Cardiology and Epidemiology, University of Minnesota, Minneapolis, MN. Review provided byVeriMed Healthcare Network.