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mitral regurgitation, acute

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Mitral valve regurgitation; acute

Alternative Names
mitral insufficiency, acute, mitral incompetence, acute

Definition
Acute mitral regurgitation is a condition that affects a valve in the heart. The mitral valve does not close completely, so that blood flows in the wrong direction.

What is going on in the body?
The mitral valve is located between the upper and lower part of the left side of the heart. In a healthy heart, blood flows from the upper to the lower part through the mitral valve. Normally, the valve alternates between being completely shut and being open to let blood pass through it.

With acute mitral regurgitation, the mitral valve no longer closes properly. With every heartbeat some blood is pumped back through the valve and into the upper part of the heart. This affects the heart and the rest of the body, too.

What are the signs and symptoms of the condition?
Symptoms of acute mitral regurgitation include:
  • shortness of breath
  • rapid breathing
  • cough, which may be constant
  • an abnormal sensation of feeling the heart beating
A doctor can hear the sound of abnormal blood flow across the valve, which is called a murmur. Another sign is a vibration, called a thrill, felt on the chest.

What are the causes and risks of the condition?
A variety of diseases can cause acute mitral regurgitation. A disorder may weaken the valve or change its position, causing a leak. Sometimes the heart itself can get weak with age. Heart attacks and infections can also cause acute mitral regurgitation. There may be a genetic cause, too, for some people.

What can be done to prevent the condition?
Proper treatment of diseases of the heart may help prevent this condition. People with heart disease or heart murmurs should ask their dentists about taking antibiotics before having dental work.

How is the condition diagnosed?
Special tests can be done to identify the cause of this problem and learn how serious it is. These include:
  • echocardiogram, which uses sound waves to allow a doctor to see the heart and find out how much blood is flowing the wrong way
  • cardiac catherisation, which places a wire into the heart to measure the amount of blood flowing in the wrong direction
What are the long-term effects of the condition?
Acute mitral regurgitation may result in death if severe and other medical problems exist. The outcome is often related to the underlying cause, such as an infection or a heart attack. People who are healthier and without other diseases do better than those with other medical problems.

What are the treatments for the condition?
Acute mitral regurgitation requires immediate medical care. Regardless of its cause, surgery is often needed to replace or repair the damaged valve. Medication and special devices may help before surgery.

What are the side effects of the treatments?
Surgical repair or replacement of the valve carries risks, such as bleeding, infection, or even death. A possible side effect of an artificial valve is an increased risk of blood clots. These small blood clots can travel in the blood and block normal blood flow to other organs.

What happens after treatment for the condition?
After recovering from surgery, a person:
  • can usually return to a normal daily routine
  • should follow any recommended diet, such as a low-sodium diet
  • should slowly increase activity
  • should tell the doctor about any change in how he or she feels
  • should see a doctor regularly to help assure that the valve is working properly
A blood-thinning medication is often prescribed after surgery to help prevent blood clots. A person should check with his or her doctor before taking any over-the-counter drugs. Some drugs can interfere with the blood-thinning medication, which can be dangerous.

How is the condition monitored?
A person who has this condition must visit the doctor for check ups and testing.

Author: Eric Berlin, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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