Heart Valve Regurgitation expert Mark Vesely, MD, sits with his laptop

Regurgitation refers to leaky heart valves (mitral or aortic) that allow some backward blood flow.

These leaky valves most commonly occur in the mitral valve.

Mitral leaking results from the valve failing to close properly, with some of the blood meant for the heart’s left ventricle instead pooling in the left atrium. Mitral regurgitation (MR) is the most common heart valve problem, with two types:

  • Functional: Other heart problems cause the heart’s lower left chamber (ventricle) to swell. That interferes with the valve’s frame (annulus) and/or its flaps (leaflets), which are otherwise intact. Functional regurgitation is also called secondary regurgitation.
  • Degenerative: Also called floppy valve syndrome, degenerative mitral valve (DMV) disease involves structural changes to the valve’s flaps (leaflets), frame (annulus) and/or tissue strings (chordae) holding it in place. This weakens the valve.

When the condition is minor, it may not require treatment. But intervention is often necessary when the heart is straining to replace the trapped blood and keep up with demand.

Mitral Valve Prolapse

There are several potential causes of degenerative mitral valve (DMV) disease:

  • Mitral valve prolapse (MVP): Prolapse is the most common cause of degenerative disease, though in many cases it is harmless. Some types are marked by excess valve tissue and others by thinning tissue. While the reasons for the changes are not always known, it appears there is a connection to aging or inherited genes. Associated names include:
    • Barlow’s disease
    • Fibroelastic deficiency
    • Billowing mitral valve
    • Click-murmur syndrome
  • Weakened heart muscle: from a previous heart attack
  • Rheumatic fever from untreated strep throat
  • Rare genetic disorders such as Marfan syndrome
  • Congenital heart defects
  • Coronary artery disease
  • High blood pressure 
  • Valve infections 

Aortic Regurgitation

Aortic regurgitation occurs when blood meant for the aorta instead flows backward through the aortic valve and pools in the left ventricle. The condition is also called aortic insufficiency.

Valve Regurgitation Symptoms

Mild regurgitation may not cause symptoms unless it worsens.

If symptoms do appear, they can develop gradually or suddenly. For mitral valve regurgitation, the sudden appearance of symptoms is often connected to a heart attack, infection or the rupture of connecting cords between muscles and the valve. 

Regurgitation symptoms can include:

  • Fatigue, exhaustion and light-headedness
  • Feeling that the heart is beating too hard, too fast, skipping a beat or fluttering (palpitations)
  • Shortness of breath that worsens with activity or when lying down
  • Rapid breathing (especially when lying on the left side in the case of mitral regurgitation)
  • Swelling of the feet, legs or abdomen
  • Cough (mitral only)
  • Excessive nighttime urination (mitral only)
  • Fainting, i.e., syncope (aortic only)

Valve Regurgitation Treatment

Our heart experts will confirm a diagnosis of heart valve regurgitation using noninvasive procedures. We have extensive experience and expertise in diagnosing this condition. We work to get your diagnosis quickly so we can begin treatment. Learn more about cardiac diagnosis.

Treatment for valve regurgitation depends on:

  • Your symptoms
  • The cause of the condition
  • The impact on the heart’s function, and whether steps are needed to protect it from further damage

Patients with mild regurgitation may only need regular checkups or medications. These medications may include:

  • Ace inhibitor: relaxes blood vessels and lowers blood pressure
  • Diuretic (water pill): removes fluid in the lungs, tissue and blood, lessening the heart’s workload
  • Beta-blocker: helps the heart beat slower, reducing the strain
  • Anti-coagulant (blood thinner): reduces the risk of faulty valves forming blood clots, which can cause a stroke
  • Anti-arrhythmic medication: restores normal heart rhythm

More severe regurgitation usually requires surgery. Learn more about: