Mitral regurgitation - acute

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Heart, section through the middle

Mitral insufficiency; Acute mitral regurgitation

• Rapid breathing
• Shortness of breath that increases when lying flat (orthopnea)
• Sensation of feeling the heart beat (palpitations)
• Chest pain -- unrelated to coronary artery disease or a heart attack
• Cough

Palpation may show thrill (vibration) over the heart. A stethoscope may reveal a distinctive murmur in the heart. However, this murmur may be absent in some cases of acute mitral regurgitation. If fluid backs up into the lungs, there may be crackles heard in the lungs. An extra heart sound (S4 gallop) may also be heard.

Blood pressure is usually normal.

The following tests may be performed:

• Echocardiogram  
• Color flow Doppler exam
• Transesophageal echocardiogram (TEE)
• Cardiac catheterization 
• Chest x-ray  - may also show fluid in the lungs or prominent pulmonary veins.
• Swan-Ganz (right heart catheterization)  - may show high left atrial pressure. 
• ECG - usually shows a normal sinus rhythm but may show arrhythmias  
• Chest MRI scan  
• Radionuclide scans
• CT scan of the chest

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