Mitral regurgitation; acute

Alternative names:

acute mitral regurgitation; mitral insufficiency

Symptoms:

• shortness of breath
• rapid respirations
• sensation of feeling the heart beat (palpitations)
• chest pain (unrelated to coronary artery disease or myocardial infarction (tissue death))
• cough

Note: There may be an abrupt onset of symptoms.

Signs and tests:

Palpation may show thrill (vibration) over the heart. A stethoscope may reveal a distinctive (holosystolic) murmur in the heart. If fluid backs up into the lungs, there may be crackles or other signs of congestion of the pulmonary (lung) veins. Blood pressure is usually normal. Billowing of the mitral valve and/or regurgitation of blood may show on:

• echocardiogram
• coronary angiography

A chest X-ray may also show fluid in the lungs or prominent pulmonary veins. Swan-Ganz (left heart catheterization) pressure readings will record a marked elevation of left atrial pressure. An ECG usually shows a normal sinus rhythm, but may show arrhythmias such as atrial fibrillation (atrial fibrillation is more common in chronic mitral regurgitation). Other tests may include a chest MRI scan, radionucleotide scans, or a CT scan of the chest.