Mitral regurgitation - acute

Alternative Names

Treatment

Hospitalization may be required for diagnosis and treatment of severe symptoms. The goal of treatment is to control the symptoms. Emergency surgery may be necessary if acute regurgitation is severe, usually resulting from endocarditis (valve infection), heart attack, or ruptured cordae (one of the supporting structures of the mitral valve).

Antibiotics may be prescribed if there is a bacterial infection. Anti-arrhythmics (drugs that regulate the heart rhythm) may be needed to control irregular rhythms. Vasodilators (drugs that dilate the blood vessels) reduce the workload of the heart. Digitalis may be used to strengthen the heartbeat and diuretics (water pills) to remove excess fluid in the lungs.

Anticoagulants or antiplatelet medications (blood thinners) may be used to prevent clot formation if atrial fibrillation is present, because atrial fibrillation increases the chances of clot formation. However, this treatment is primarily used for chronic mitral regurgitation.

In emergency situations when blood pressure cannot be maintained, devices such as the intra-aortic balloon pump (IABP) reduce backflow by enhancing forward blood flow into the aorta.

Outlook (Prognosis)

The outcome varies and depends on underlying conditions and the severity of the acute regurgitation. Milder forms of acute mitral regurgitation may become a chronic condition. Acute mitral regurgitation can rarely be controlled with medications; surgery is usually necessary to repair or replace the mitral valve (see valve replacement). Arrhythmias associated with acute mitral regurgitation can sometimes be fatal.

Possible Complications

• Chronic mitral regurgitation
• Endocarditis (valve infection)
• Heart failure
• Pulmonary edema (fluid in the lungs)
• Stroke
• Blood clots in other parts of the body 
• Arrhythmias, including atrial fibrillation

When to Contact a Medical Professional

Call your health care provider if symptoms indicate mitral valve regurgitation, or if symptoms worsen or do not improve with treatment. Call your health care provider if during treatment, signs of infection occur: fever, chills, muscle aches, headache, or malaise (general ill feeling).