Mitral Insufficiency

Mitral insufficiency, also known as mitral regurgitation or mitral incompetence, is a common form of valvular heart disease.

What is mitral insufficiency?

Mitral insufficiency occurs when the mitral valve does not close properly, allowing blood to flow backwards into the heart. As a result, the heart cannot pump efficiently, causing symptoms like fatigue and shortness of breath. Mild mitral insufficiency may cause little to no problems, while a more severe case may lead to pulmonary hypertension, atrial fibrillation, or heart failure.

If the leakage is mild, treatment may not be necessary. In more severe cases, your condition may require heart surgery to repair or replace the valve.

What causes mitral insufficiency?

The mitral valve, one of four valves within the heart, controls the flow of blood between the left atrium and the left ventricle. The mitral valve opens to allow blood to flow into the left ventricle and then closes to prevent blood from flowing back into the left atrium. In mitral insufficiency, the two flaps of the mitral valve, called leaflets, do not close tightly and can leak or flow in the wrong direction. this condition is also commonly known as mitral regurgitation or mitral incompetence.

Mitral insufficiency may occur because of problems with the left ventricle, causing the valve to not close tightly. This can lead to blood leaking backward into the left atrium. You are at an increased risk for mitral insufficiency as you age, if you’ve had rheumatic fever. Heart failure and coronary artery disease also put you at an elevated risk.

What are the symptoms of mitral insufficiency?

The symptoms of mitral insufficiency depend on the severity of the disease. Mitral insufficiency symptoms may include:

• Heart murmur
• Shortness of breath, upon exertion or when lying flat
• Coughing during the night
• Accumulation of fluid in the lungs
• Fatigue
• Swelling of legs and feet

In many cases, patients experience little to no symptoms at all. If you notice these symptoms or if your symptoms suddenly worsen, make an appointment with an SSM Health heart and vascular specialist as soon as possible.

How is mitral insufficiency treated?

We may treat your mitral insufficiency medically or surgically, depending on the symptoms and the condition and function of your heart.

Medication is an option for some patients:

Patients with high blood pressure or a weakened heart muscle may be given medication to reduce the strain on the heart and help improve their condition.

Surgical mitral valve replacement or repair options:

If your symptoms become more severe and heart function is poor, an expert team of SSM Health cardiovascular surgeons will repair or replace the mitral valve through the “keyhole” method. This minimally invasive procedure is performed through a small incision in the side of the chest, greatly reducing complications, pain, scarring and recovery time.

What is MitraClip™ repair?

Heart specialists at SSM Health are now using a less-invasive option for the treatment of patients’ leaky mitral valves. This minimally-invasive option is bringing greater relief from the debilitating symptoms of mitral regurgitation to patients who are not candidates for traditional valve repair.

Traditional valve repair surgery is a common procedure that has been proven both safe and effective. However, it does require incisions in the chest and a temporary stop of the heart. The MitraClip™ allows our physicians to offer a less invasive treatment option for patients who may not be candidates for traditional surgical valve repair. Studies have shown surgical repair with the MitraClip™ reduces the risk of hospitalization for heart failure.