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Mitral regurgitation - acute - Symptom

Alternative Names

Mitral insufficiency; Acute mitral regurgitation

Symptoms:

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

Note: Symptoms may start suddenly.

Signs and tests:

The doctor may detect a thrill (vibration) over the heart when feeling (palpating) 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.

Blood pressure is usually normal.

The following tests may be performed:

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

Heart, section through the middle

Reviewed last on: 5/12/2008
Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, and Private practice specializing in Cardiovascular Disease, Watertown, MA. 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.

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