Mitral regurgitation; chronic

Alternative names:

chronic mitral valve regurgitation

Symptoms:

• fatigue and exhaustion (may result from low cardiac output)
• palpitations (related to atrial fibrillation)
• cough
• shortness of breath
  • with exertion (exertional dyspnea)
  • when lying down (orthopnea)

• weight loss

Additional symptoms that may be associated with this disease:

• urination, excessive at night

Note: Often no symptoms are present. When symptoms occur they often develop gradually.

Signs and tests:

Palpation may show thrill (vibration) over the heart. A stethoscope examination of the heart reveals a distinctive (holosystolic) murmur. Rales or other abnormal breath sounds may be heard on lung examination. Ankle edema, enlarged liver, distended neck veins, and other signs consistent with right-sided heart failure may be present.

An enlarged left atrium with thickened or deformed mitral valve, and regurgitation of blood may show on:

• echocardiogram
• coronary angiography

A chest X-ray may show an enlarged left atrium. An ECG often shows atrial fibrillation with a peaked P-wave, suggestive of left atrial enlargement. Other tests may include chest MRI, radionucleotide scans, or a CT scan of the chest.