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Mitral Regurgitation

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Overview of Mitral Regurgitation

Mitral Regurgitation Meaning in Urdu

یہ بیماری دل کو متاثر کرتی ہے جس کی وجہ سے دل کے بائیں حصے میں موجود والو مکمل طور پر بند نہیں ہو پاتی۔ جب یہ والو مکمل طور پر بند نہیں ہوتی تو پچھلی جانب اس والو کے ساتھ خون بہنے لگتا ہے۔ اگر اس والو کے ساتھ بہت زیادہ خون بہے کو مریض کو شدید تھکاوٹ کا سامنا کرنا پڑ سکتا ہے۔ اس کے ساتھ ساتھ اس بیماری کے شکار افراد کو دل کی دھڑکن کی بے ترتیبی، سانس لینے میں مشکلات، اور پاؤں یا ٹخنوں کی سوزش بھی لاحق ہو سکتی ہے۔

Mitral regurgitation is a heart valve disorder where the mitral valve, located between the left atrium and the left ventricle of the heart, does not close properly, causing blood to leak back into the atrium during the contraction of the ventricle. This results in some of the blood being pumped back into the lungs instead of flowing to the body.

Prevalence of Mitral Regurgitation

Globally, Mitral Regurgitation is a common valvular abnormality, affecting 2% of the total population, and has a prevalence that increases with age. 

Signs and Symptoms of Mitral Regurgitation

Mitral regurgitation symptoms can vary depending on the severity of the condition. Mild cases may not produce any noticeable symptoms, while more severe cases may result in the following:

  • Fatigue and weakness
  • Shortness of breath, especially during physical activity or when lying down
  • Coughing, especially at night or when lying down
  • Heart palpitations or a rapid or irregular heartbeat
  • Chest discomfort or pain
  • Swelling of the feet or ankles
  • Decreased ability to exercise or participate in physical activities

These symptoms can also be present in other heart conditions, so it is essential to see a healthcare provider if you experience any.

Types of Mitral Regurgitation

There are two main types of mitral regurgitation:

  • Primary Mitral Regurgitation: It occurs when the mitral valve itself is structurally abnormal, such as in cases of mitral valve prolapse or congenital heart defects. Primary mitral regurgitation is the most common type and can progress over time.
  • Secondary Mitral Regurgitation: Known as functional mitral regurgitation, it occurs when the left ventricle of the heart gets enlarged or weakened, causing the mitral valve to leak. People with heart failure or a history of a heart attack are more prone to secondary mitral regurgitation. 

There is also a third type of mitral regurgitation known as acute mitral regurgitation. It can occur suddenly due to trauma, infection, or a tear in the valve. Acute mitral regurgitation is a medical emergency and requires immediate treatment.

Some cases of mitral regurgitation may be a combination of primary and secondary types. Treatment options and prognosis will vary depending on the type and severity of mitral regurgitation.

Causes of Mitral Regurgitation

Mitral regurgitation causes point toward many factors, including:

  • Mitral Valve Prolapse: It occurs when the leaflets of the mitral valve don't close properly, causing the valve to leak.
  • Rheumatic Fever: A condition caused by a streptococcal infection that can damage the heart valves, including the mitral valve.
  • Congenital Heart Defects: Some people are born with abnormalities in the structure of their mitral valves. 
  • Heart Attack: A heart attack can damage the muscles that support the mitral valve, leading to leakage.
  • Dilated Cardiomyopathy: A condition where the heart becomes enlarged and weakened, causing the mitral valve to leak.
  • Infective Endocarditis: A bacterial infection that can damage heart valves, including the mitral valve.
  • Age-related Degeneration: With aging, the mitral valve can become stiff and calcified, causing it to leak.
  • Connective Tissue Disorders: Certain connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, can cause mitral valve prolapse and subsequent regurgitation.

The severity of mitral regurgitation can vary depending on the underlying cause, and treatment options will depend on the severity of the condition and the specific cause.

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Risk Factors of Mitral Regurgitation

Several risk factors can increase the likelihood of developing mitral regurgitation. These risk factors include:

  • Age: Mitral regurgitation is more common in older adults, especially those over 75.
  • Genetics: Certain genetic conditions can increase the risk of developing mitral valve disorders, including Marfan syndrome and Ehlers-Danlos syndrome.
  • Rheumatic Fever: Rheumatic fever is a complication of untreated strep throat that can damage the heart valves, including the mitral valve.
  • Endocarditis: Endocarditis is an infection of the heart valves that can lead to damage and dysfunction.
  • Cardiomyopathy: Certain types of cardiomyopathy can lead to mitral regurgitation, particularly when the heart gets enlarged.
  • Previous Heart Attack: A prior heart attack can cause damage to the heart muscle, leading to mitral regurgitation.
  • Congenital Heart Defects: Certain congenital heart defects, such as a cleft mitral valve, can increase the risk of developing mitral regurgitation.
  • Other Heart Conditions: Other heart conditions, such as mitral valve prolapse or aortic stenosis, can increase the risk of developing mitral regurgitation.

It's important to note that not all individuals with these risk factors will develop mitral regurgitation. Everyone should know about these risk factors and discuss any concerns with a Cardiologist. 

Health Complications Due to Mitral Regurgitation

Over time, Mitral Regurgitation can lead to a variety of complications, including:

  • Heart failure: If left untreated, mitral regurgitation can cause the heart to enlarge and weaken, which can eventually lead to heart failure.
  • Atrial fibrillation: It is a condition in which the heart’s upper chambers (the atria) beat irregularly and rapidly. Atrial fibrillation can cause palpitations, shortness of breath, and other symptoms.
  • Pulmonary hypertension: Mitral regurgitation can cause high blood pressure in the pulmonary arteries, leading to pulmonary hypertension. It can cause shortness of breath, fatigue, and chest pain.
  • Endocarditis: Mitral regurgitation can increase the risk of developing endocarditis, which is an infection of the heart's inner lining.
  • Stroke: If blood clots form in the heart due to the abnormal blood flow caused by mitral regurgitation, they can travel to the brain and cause a stroke.
  • Cardiac arrest: In severe cases, mitral regurgitation can cause sudden cardiac arrest, a medical emergency that requires immediate treatment.
  • Arrhythmias: Mitral regurgitation can cause irregular heart rhythms, leading to palpitations, dizziness, and fainting.

It's important to seek medical attention if you experience any symptoms of mitral regurgitation or have a history of heart disease. Early diagnosis and treatment can help prevent complications and improve outcomes.

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Prevention

Mitral Regurgitation prevention depends on the underlying cause, which can include:

  • Preventing Heart Disease: MR is often caused by heart disease, such as mitral valve prolapse, rheumatic fever, or infective endocarditis. To prevent MR, it's essential to manage any underlying heart disease by maintaining a healthy lifestyle, including a nutritious diet, regular exercise, avoiding smoking, and limiting alcohol intake.
  • Treating high blood pressure: High blood pressure can lead to heart disease and MR. Therefore, it's crucial to manage hypertension by following a healthy diet, exercising regularly, taking medication as prescribed, and managing stress.
  • Managing heart failure: Heart failure is a common cause of MR, and it's essential to manage heart failure by following the doctor's recommended treatment plan, including medication, lifestyle changes, and regular monitoring.
  • Taking antibiotics for infective endocarditis: Infective endocarditis is an infection of the heart valves that can lead to Mitral Regurgitation. If you are at risk of developing infective endocarditis, your doctor may recommend antibiotics before dental or surgical procedures.
  • Avoiding certain medications: Some medications can cause or worsen MR, such as certain chemotherapy drugs, so it's important to talk to your doctor about any medications you're taking and their potential risks.
  • Regularly monitoring and treating any underlying health conditions: Regular checkups with your doctor can help identify any underlying health conditions that can lead to MR, and prompt treatment can prevent the development of MR.

In summary, preventing MR involves managing underlying health conditions, maintaining a healthy lifestyle, and following your doctor's recommendations.

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Diagnosis

The options for Mitral Regurgitation diagnosis include:

  • Physical examination: A doctor may listen to your heart with a stethoscope and look for specific signs, such as a murmur, to suggest the presence of mitral regurgitation.
  • Echocardiography: Echocardiography is a non-invasive imaging test that uses sound waves to create images of the heart. This test can reveal the extent of the mitral regurgitation, the severity of the condition, and any underlying causes.
  • Electrocardiogram (ECG): An ECG records the electrical activity of the heart and can help identify any abnormal rhythms or patterns associated with mitral regurgitation.
  • Chest X-ray: A chest X-ray can reveal any abnormalities in the heart size or shape associated with mitral regurgitation.
  • Cardiac MRI: Cardiac MRI uses magnetic fields and radio waves to produce detailed images of the heart. This test can help identify the extent of the mitral regurgitation, the severity of the condition, and any underlying causes.
  • Cardiac catheterization: During this procedure, a thin tube is inserted into a blood vessel in the groin and guided to the heart. This test can help measure the pressure inside the heart and the blood flow through the valves.

It is important to consult with a healthcare provider for proper diagnosis and treatment of mitral regurgitation.

Treatment of Mitral Regurgitation | When to Consult a Doctor

Mitral regurgitation treatment depends on the severity of the condition and the underlying cause. Here are some common treatments for mitral regurgitation:

  • Medications: If the mitral regurgitation is mild, your doctor may prescribe medications to help control symptoms and slow the progression. These medications may include ACE inhibitors, beta-blockers, and diuretics.

  • Surgery: If the mitral regurgitation is severe or getting worse, surgery may be necessary. Surgery type will depend on the cause and severity of the condition, and the patient's overall health. Some common surgical procedures for mitral regurgitation include:

    • Mitral Valve Repair: This surgery is the preferred treatment option if possible. The surgeon will repair the damaged valve instead of replacing it, which can help preserve the valve and improve the long-term outlook for the patient.

    • Mitral Valve Replacement: If the valve is severely damaged or cannot be repaired, it may need to be replaced. The replacement valve may be mechanical or made from animal tissue.

    • Watchful Waiting: In some cases, if the mitral regurgitation is mild and not causing any symptoms, your doctor may recommend watchful waiting. It means monitoring the condition regularly with echocardiograms and other tests to make sure it's not getting worse.

It's important to work closely with a cardiologist to determine the best treatment plan for your situation.

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