Patients may be asymptomatic or may have manifestations like fatigue caused by reduced cardiac output, tachypnea or dyspnea, orthopnea, paroxysmal nocturnal dyspnea and hemoptysis due to pulmonary hypertension [1]. When atrial fibrillation due to left atrium dilatation occurs, most patients experience palpitations. In children, failure to thrive is an important hallmark of almost all serious heart conditions.

When mitral regurgitation happens abruptly, being caused by an acute accident like chordal or papillary muscle rupture due to myocardial infarction, compensatory mechanisms do not have time to install and symptoms are dramatic, as patients present with pulmonary edema or cardiogenic shock. In chronic severe mitral regurgitation, patients slowly progress to congestive heart failure and pulmonary edema [2].

• Fatigue

  They include: A racing or irregular heartbeat (arrhythmia) Dizziness or feeling lightheaded Shortness of breath Fatigue Chest pain Mitral valve stenosis For some, the primary and often only symptom of mitral stenosis is shortness of breath. [heartvalvedisease.nm.org]

  This leads to congestive heart failure, which causes fatigue, fluid retention and shortness of breath. Additionally, the leakiness of the valve burdens the heart and causes it to work harder. Eventually the heart becomes weakened and enlarged. [beaumont.edu]

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019 [patientslikeme.com]

  Patients may be asymptomatic or may have manifestations like fatigue caused by reduced cardiac output, tachypnea or dyspnea, orthopnea, paroxysmal nocturnal dyspnea and hemoptysis due to pulmonary hypertension. [symptoma.com]

• Congestive Heart Failure

  If the condition persists, the patient can also develop atrial fibrillation and potentially congestive heart failure, leading to shortness of breadth, dizziness, chest pain, and fatigue. [myocor.com]

  Complications congestive heart failure pulmonary hypertension mass-effect from left atrial enlargement (e.g. [radiopaedia.org]

  In chronic severe mitral regurgitation, patients slowly progress to congestive heart failure and pulmonary edema. A clinical examination reveals a left atrial lift caused by the left atrium filling with blood during systole. [symptoma.com]

• Weakness

  Mitral regurgitation is caused by damage or weakness of the mitral valve. [drugs.com]

  The valve or its supporting structures can be damaged by a heart attack, coronary artery disease, or weakness in the tissues of these structures (myxomatous degeneration). [merckmanuals.com]

  Symptoms of acute mitral valve regurgitation including severe shortness of breath, fast heart rate, lightheadedness, weakness, confusion, and chest pain. [uofmhealth.org]

• Cough

  In acute or chronic decompensated MR, pulmonary edema and pulmonary hypertension often cause dyspnea, coughing, jugular venous distention, and pitting edema. [amboss.com]

  Symptoms of mitral valve stenosis may include: Shortness of breath Cough due to fluid on the lungs (pulmonary edema) A rapid, fluttering heartbeat (palpitations) Dizziness or lightheadedness Swollen feet or legs Blood clots Chest pain [heartvalvedisease.nm.org]

  This may produce symptoms ranging from shortness of breath during exertion, coughing, congestion around the heart and lungs, swelling of the legs and feet. [cardiomyopathy.org]

  You may be at risk if you experience these symptoms: Difficulty breathing, especially during exercise or when lying flat Awakening short of breath in the middle of the night Fatigue Sensation of rapid or irregular heartbeat Cough with exertion or when [uvahealth.com]

• Dyspnea

  The patients were referred to our cardiovascular department because of exertional dyspnea. Echocardiography showed severe mitral valve insufficiency resulting from leaflet flail or prolapse and normal left ventricular function. [ncbi.nlm.nih.gov]

  Patients may be asymptomatic or may have manifestations like fatigue caused by reduced cardiac output, tachypnea or dyspnea, orthopnea, paroxysmal nocturnal dyspnea and hemoptysis due to pulmonary hypertension. [symptoma.com]

  Symptoms such as palpitations or dyspnea appear late in the course of chronic compensated MR in which cardiac output can still be maintained. [amboss.com]

  A 44-year-old man presents with dyspnea and new atrial fibrillation. He received a diagnosis of mild mitral regurgitation at 28 years of age but has not seen a physician in many years. [nejm.org]

  Loop diuretics such as furosemide are helpful in patients with exertional or nocturnal dyspnea. Digoxin may reduce symptoms in patients with AF or those in whom valve surgery is not appropriate. [merckmanuals.com]

• Orthopnea

  Patients may be asymptomatic or may have manifestations like fatigue caused by reduced cardiac output, tachypnea or dyspnea, orthopnea, paroxysmal nocturnal dyspnea and hemoptysis due to pulmonary hypertension. [symptoma.com]

  […] coronary artery disease and acute myocardial infarction (typically, inferior myocardial infarction, which may lead to papillary muscle dysfunction), significant acute MR is accompanied by symptoms of impaired LV function, such as dyspnea, fatigue, and orthopnea [emedicine.medscape.com]

  Individuals with acute mitral regurgitation will have the signs and symptoms of decompensated congestive heart failure (i.e. shortness of breath, pulmonary edema, orthopnea, and paroxysmal nocturnal dyspnea), as well as symptoms suggestive of a low cardiac [slideshare.net]

  Symptoms include dyspnea, fatigue (due to heart failure), orthopnea, and palpitations (often due to atrial fibrillation). Rarely, patients present with endocarditis (eg, fever, weight loss, embolic phenomena). [merckmanuals.com]

  Individuals with acute MR are typically severely symptomatic and will have the signs and symptoms of acute decompensated congestive heart failure (i.e. shortness of breath, pulmonary edema, orthopnea, and paroxysmal nocturnal dyspnea[3]), as well as symptoms [en.wikipedia.org]

• Hemoptysis

  Patients may be asymptomatic or may have manifestations like fatigue caused by reduced cardiac output, tachypnea or dyspnea, orthopnea, paroxysmal nocturnal dyspnea and hemoptysis due to pulmonary hypertension. [symptoma.com]

  Other less common symptoms include hemoptysis, thromboembolism or symptoms of infectious endocarditis. Acute mitral regurgitation presents with dramatic symptoms. Syncope can occur from sudden hypotension related to cardiogenic shock. [healio.com]

• Dry Cough

  cough Palpitations Symptoms of left-sided heart failure References:[2] Diagnostics Auscultation See “Auscultation in valvular defects” Quiet first heart sound (S1) S3 gallop in advanced stages of disease Holosystolic murmur Radiates to the left axilla [amboss.com]

  Symptoms Dry cough Difficulty breathing Stagnation of blood vessels in the lungs Heart palpitations Irregular heartbeat Upheavals in the left side of the chest Patients with insufficient mitral valve can also feel dizziness in the morning or before the [bookinghealth.com]

• Failure to Thrive

  In children, failure to thrive is an important hallmark of almost all serious heart conditions. [symptoma.com]

• Heart Disease

  You are at risk for mitral valve regurgitation if you have: Coronary heart disease and high blood pressure Infection of the heart valves Mitral valve prolapse (MVP) Rare conditions, such as untreated syphilis or Marfan syndrome Rheumatic heart disease [mountsinai.org]

  Valvular Heart Disease. Braunwald's Heart Disease. 8th ed. Philadelphia, PA: Saunders Elsevier; 2008. chap. 62. Thourani VH, Weintraub WS, Guyton RA, et al. [emedicine.medscape.com]

• Mitral Valve Prolapse

  Convert to ICD-10-CM : 394.1 converts directly to: 2015/16 ICD-10-CM I05.1 Rheumatic mitral insufficiency Approximate Synonyms Mitral regurgitation Mitral valve prolapse, rheumatic Mitral valve regurgitation, rheumatic Rheumatic mitral regurgitation Rheumatic [icd9data.com]

  Mitral valve prolapse is accompanied by an ejection systolic click. The murmur caused by mitral regurgitation is best heard at the apex and radiates towards the axilla and subscapular area. [symptoma.com]

  Post Mitral Valve Prolapse - Symptoms What symptoms did you experience with your mitral valve prolapse? Post View 22 Comments Mitral Valve Prolapse - Experience Please share your experience with mitral valve prolapse. [emedicinehealth.com]

  Mitral Valve Prolapse Mitral valve prolapse is defined as the displacement of one or both of the leaflets of the mitral valve beyond the annulus into the left atrium during systole.1 Historically a mitral valve prolapse syndrome has been described as [acc.org]

  Symptoms of mitral valve prolapse Most patients with mitral valve prolapse have no symptoms. But some patients do have symptoms associated with mitral valve prolapse. [cormedicalgroup.com]

• Palpitations

  Symptoms of mitral valve stenosis may include: Shortness of breath Cough due to fluid on the lungs (pulmonary edema) A rapid, fluttering heartbeat (palpitations) Dizziness or lightheadedness Swollen feet or legs Blood clots Chest pain [heartvalvedisease.nm.org]

  Mitral Valve Prolapse Symptom - Heart Palpitations Heart palpitations are one symptom of a heart condition called mitral valve prolapse (a very common heart valve abnormality). [emedicinehealth.com]

  Symptoms such as palpitations or dyspnea appear late in the course of chronic compensated MR in which cardiac output can still be maintained. [amboss.com]

  When atrial fibrillation due to left atrium dilatation occurs, most patients experience palpitations. In children, failure to thrive is an important hallmark of almost all serious heart conditions. [symptoma.com]

  Palpitations are sensations of fast or irregular heart beats. In most people with mitral valve prolapse, palpitations are harmless. [medicinenet.com]

• Heart Murmur

  When to see a doctor If your doctor hears a heart murmur when listening to your heart with a stethoscope, he or she may recommend that you visit a cardiologist and get an echocardiogram. [mayoclinic.org]

  To ensure proper cardiac function, please remember to get regular, annual check-ups if you have been diagnosed with a heart murmur, a mitral valve prolapse or mitral valve regurgitation. [heart-valve-surgery.com]

  Mitral valve regurgitation is often first suspected when a doctor hears a heart murmur. Sometimes, however, the problem develops quickly, and people may experience a sudden onset of severe signs and symptoms. [columbiasurgery.org]

• Systolic Murmur

  Forty-five patients had a pan-systolic murmur and 37 had a late-systolic murmur on auscultation that was verified by timing of onset of regurgitant turbulence by cine magnetic resonance imaging. [ncbi.nlm.nih.gov]

  Systolic Murmurs - Mitral Regurgitation You are listening to a typical example of a murmur caused by mitral valve regurgitation. [med.ucla.edu]

• Dizziness

  Symptoms of mitral valve stenosis may include: Shortness of breath Cough due to fluid on the lungs (pulmonary edema) A rapid, fluttering heartbeat (palpitations) Dizziness or lightheadedness Swollen feet or legs Blood clots Chest pain [heartvalvedisease.nm.org]

  […] practitioner if the pulse rate is outside the parameters dietary restrictions, including the need to maintain low salt intake prescribed medications, such as diuretics and ACE inhibitors and potential adverse effects, such as orthostatic hypotension, dizziness [quizlet.com]

  Symptoms include evidence of a heart rhythm disorder, such as dizziness, blackout, or fainting spell, or a continuing and uncomfortable feeling that the heart is fluttering or racing. Chest pain does not go away. [emedicinehealth.com]

  Some people with this condition may not feel any symptoms while others may have chest pain, shortness of breath, an irregular heartbeat, or dizziness, among other things. [webmd.com]

  If the condition persists, the patient can also develop atrial fibrillation and potentially congestive heart failure, leading to shortness of breadth, dizziness, chest pain, and fatigue. [myocor.com]

A clinical examination reveals a left atrial lift caused by the left atrium filling with blood during systole. The first heart sound is normal or diminished, while the second heart sound is split into early stages of the disease because the aortic valve closes early. The splitting interval diminishes as pulmonary hypertension starts [1]. A third sound caused by increased ventricular filling may also appear, while the pulmonary component of the second heart sound is accentuated if pulmonary hypertension has begun. Mitral valve prolapse is accompanied by an ejection systolic click.

The murmur caused by mitral regurgitation is best heard at the apex and radiates towards the axilla and subscapular area. It is usually pansystolic, but may also be presystolic in acute settings or telesystolic in mitral valve prolapse or papillary muscle dysfunction. The intensity decreases as the left ventricle dysfunction advances [2].

Peripheral pulse is sharp but has a small volume; atrial fibrillation presents late in the course of the disease and the characteristic pulse abnormality is noted. The dilated left atrium may compress the left main bronchus, leading to wheezing and, rarely, lung atelectasis and hyperinflation.

The postero-anterior radiography may show a normal aspect of the heart or enlarged left atrium and left atrial appendage; if mitral regurgitation begins abruptly, the X-ray shows signs of pulmonary edema with normal sized left atrium. The pulmonary edema might be more prominent in the right upper lobe [3]. Cardiomegaly is present in chronic regurgitations.

Echocardiography is the most valuable tool in assessing mitral regurgitation. Two-dimensional (2D) echocardiography is useful in measuring heart dimensions and characterizing the mitral apparatus while trying to identify the cause of the disease and associated abnormalities. Color flow echocardiography describes the direction of the flow [4]. Quantitative and semi-quantitative measurement methods should be used in evaluating disease severity [5].

Spectral Doppler (pulse and continuous) is useful in calculating the severity of the regurgitation (by measuring parameters such as vena contracta, proximal isovelocity surface area, and regurgitant fraction) and evaluating a possible concomitant mitral stenosis [5]. If doubt about severity persists, stress echocardiography and exercise testing should be performed [2].

Transesophageal echocardiography and heart catheterization are indicated in cases where heart anatomy is uncertain [6], whereas cardiac magnetic resonance imaging (MRI) is more accurate in determining ventricular function and size. Catheterization is also useful in grading the regurgitation [7].

Electrocardiography shows rhythm and conduction abnormalities, left atrial enlargement and right ventricular hypertrophy if pulmonary hypertension is present.

Brain natriuretic peptide has prognostic value in severe mitral regurgitation and can be used in risk stratification [8].

• P Mitrale

  Harrison's Internal Medicine 17th edition a b medilexicon.com P mitrale Citing. Stedman's Medical Dictionary. Copyright 2006 Greenberg BH, Massie BM, Brundage BH, Botvinick EH, Parmley WW, Chatterjee K (1978). [en.wikipedia.org]

  Retrieved 2010-06-30. a b medilexicon.com P mitrale Citing. Stedmans Medical Dictionary. Copyright 2006 Greenberg BH, Massie BM, Brundage BH, Botvinick EH, Parmley WW, Chatterjee K (1978). [slideshare.net]

  The most common finding is left atrial enlargement (P mitrale), but this finding disappears if the patient enters atrial fibrillation. Right heart strain may produce findings of right axis deviation and right ventricular hypertrophy on ECG. [healio.com]

1. Nishimura RA, Otto CM, Benow RO, et al. 2014 AHA/ACC guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. JACC 2014;63(22):e60-e185
2. Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012): The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2012;33(19):2451-2496.
3. Schnyder PA, Sarraj AM, Duvoisin BE, et al. Pulmonary edema associated with mitral regurgitation: prevalence of predominant involvement of the right upper lobe. AJR Am J Roentgenol. 1993;161(1): 33-36.
4. Little SH, Pirat B, Kumar R, et al. Three-dimensional color Doppler echocardiography for direct measurement of vena contracta area in mitral regurgitation: in vitro validation and clinical experience. JACC Cardiovasc Imaging. 2008;1(6):695-704.
5. Zoghbi WA, Enriquez-Sarano M, Foster E et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 2003;16(7):777-802.
6. Calafiore AM, Gallina S, Iaco AL, et al. Mitral valve surgery for functional mitral regurgitation: should moderate-or-more tricuspid regurgitation be treated? a propensity score analysis. Ann Thorac Surg. 2009;87(3):698-703.
7. Bonow RO, Carabello BA, Kanu C, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. 2006;114(5):e84-231.
8. Pizarro R, Bazzino OO, Oberti PF, et al. Prospective validation of the prognostic usefulness of brain natriuretic peptide in asymptomatic patients with chronic severe mitral regurgitation. J Am Coll Cardiol. 2009;54(12):1099-1106.