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Mitral regurgitation - chronic - Symptom

Alternative Names

Chronic mitral valve regurgitation; Mitral valve insufficiency

Symptoms:

There are often no symptoms. When symptoms occur, they often develop gradually, and may include:

Cough
Fatigue, exhaustion, and light-headedness
Palpitations (related to atrial fibrillation)
Shortness of breath during activity and when lying down
Urination, excessive at night

Signs and tests:

The doctor may detect a thrill (vibration) over the heart when feeling the chest area. An extra heart sound (S4 gallop) and a distinctive heart murmur may be heard when listening to the chest with a stethoscope. However, some patients may not have this murmur. If fluid backs up into the lungs, there may be crackles heard in the lungs.

The physical exam may also reveal ankle swelling, enlarged liver, distended neck veins, and other signs consistent with right-sided heart failure.

The following tests may be done:

Cardiac color-Doppler study
Cardiac catheterization
Chest x-ray
CT scan of the chest
ECG
Echocardiogram (an ultrasound examination of the heart)
Magnetic resonance imaging (MRI)
Radionuclide scans
Transesophageal echocardiogram (TEE)

Heart, section through the middle

Heart, front view

Reviewed last on: 5/6/2010
Issam Mikati, MD, Associate Professor of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Karchmer AW. Infectious endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 63.

Nishimura RA, Carabello BA, Faxon DP, et al. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52:676-685.

Fullerton DA, Harken AH. Acquired heart disease: valvular. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Sunders Elsevier;2008:chap 62.

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