The condition known as mitral regurgitation, also known as mitral valve regurgitation, occurs when the mitral valve malfunctions and blood escapes the heart out the back. On the left side of your heart, in the space between the two chambers, is the mitral valve.
According to guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC), mitral regurgitation is categorized into four stages, A through D, based on how severe the symptoms and signs are. The least severe stage is A, while the most severe stage is D.
Let’s take a closer look at each stage of mitral valve regurgitation.
Mitral valve and heart anatomy
Your left atrium and left ventricle are where you’ll find your mitral valve. It consists of multiple structures that are susceptible to damage, such as:
- Leaflets: two opening and closing mechanisms that allow blood to pass through
- Mitral annulus: a fibrous ring serving as the location of leaflet insertion
- Chordae tendineae (chords): strands of fibre that pull the leaflets open
- Papillary muscles: Your leaflets open by pulling on the chordae tendineae muscles.
Stage A mitral regurgitation: At risk.
Individuals at stage A possess:
- no symptoms
- no associated anatomical alterations brought on by variations in blood flow in their heart
- typical cords, annulus, and leaflets when cardiomyopathy or coronary artery disease is present
- minimal mitral regurgitation
Treatment
- reducing sodium intake
- reducing weight if you’re obese or overweight
- limiting alcohol
- quitting or avoiding smoking
Stage B mitral regurgitation: Progressive
Individuals in stage B may have:
- mild left atrial enlargement
- mild mitral regurgitation
- no expansion of the left ventricle or alteration of the blood arteries that supply the lungs
- mild to severe prolapse of the mitral valve, which causes the valve to buckle inward into the left atrium
- moderate constriction of the leaflets of the mitral valve and enlargement of the mitral annulus
Treatment
Stage C mitral regurgitation: Asymptomatic severe
- severe mitral valve prolapse
- severe mitral regurgitation
- left ventricle enlargement
- thickness of the leaflets, potentially brought on by radiation treatment to the chest or an illness
- inflammation of the valves with leaflet restriction
- Mild to severe swelling of the left atrium
- pulmonary hypertension during activity or at rest
Treatment
When it is feasible, experts advise mitral valve repair over replacement.
Stage D mitral regurgitation: Symptomatic severe
- fatigue
- a reduced exercise capacity
- breathlessness during rest or activity
- heart palpitations
- chest pain
- swelling in their
- legs
- abdomen
- neck veins
Treatment
How do doctors determine the mitral regurgitation stage?
- a physical exam
- a review of your symptoms
- angiography
- electrocardiography (ECG)
- echocardiogram
What is the life expectancy with mitral regurgitation by stage?
In a 2018 study, researchers observed that individuals who underwent mitral valve surgery had survival rates similar to those in the general population, based on 83 participants with an average age of 57 and no symptoms. In the study, there was no early death rate.
In general, experts believe that mitral valve repair is more survivable than mitral valve replacement.
Takeaway
If your mitral valve regurgitation is in stage C2 or stage D, your doctor is likely to suggest surgery. Studies show that replacing the mitral valve is not as beneficial to survival as repairing it.
It’s critical to follow up with a physician frequently if you are diagnosed with mitral valve regurgitation to determine whether your condition is becoming worse.