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Mitral insufficiency, also called mitral regurgitation, occurs when the mitral valve, which is a structure of the heart that separates the left atrium from the left ventricle of the heart when it is closed, is defective, which results in altered blood circulation, leading to the appearance of some symptoms, such as shortness of breath and swelling in the feet and ankles, for example.
In mitral regurgitation, the mitral valve, which allows blood to pass from the left atrium to the left ventricle, does not close completely, causing a small volume of blood to return to the lungs instead of leaving the heart to irrigate the body, as it should .
Circulation is more impaired the more damaged the mitral valve is, which normally loses strength with age, or after a myocardial infarction, for example. However, mitral insufficiency can also be a birth problem. Either way, mitral regurgitation can be treated with medication or surgery.
Symptoms of Mitral Insufficiency
Symptoms of Mitral Insufficiency can take years to appear, since this change happens gradually, and is therefore more frequent in people with a little more advanced age. The main symptoms indicative of Mitral Insufficiency are:
- Shortness of breath, especially when making some effort or when going to sleep;
- Tiredness;
- Cough, especially at night;
- Heart palpitations and racing heart;
- Swelling in the feet and ankles.
In the presence of these symptoms, the person should consult the cardiologist so that heart auscultation can be performed as well as other exams, such as electrocardiogram, chest X-ray or echocardiography to assess the severity of the mitral valve.
Causes of mitral regurgitation
Mitral insufficiency can happen due to coronary heart disease, rheumatic diseases, infectious endocarditis, collagen-related diseases, such as Maritime Syndrome, for example, and as a side effect of medications, such as Fenfluramine or Ergotamine, for example.
In addition, failure can happen as a result of the mitral valve itself due to aging, be a birth problem or happen after a heart attack, as the mitral valve can be affected, and there is also a greater risk of developing mitral failure if there is any family history of the disease.
How is the treatment
The treatment for Mitral Insufficiency varies according to the severity of the disease, however the cardiologist usually indicates the use of diuretic drugs, beta-blockers or angiotensin-converting enzyme inhibitors. In more severe cases, it is recommended to perform cardiac surgery to correct or replace the mitral valve, which is known as valvuloplasty. Understand how valvuloplasty is performed.
Types of Mitral Insufficiency
Mitral insufficiency can be classified into several types according to the severity of the symptoms and causes in:
- Mild, minimal or mild mitral regurgitation, which does not produce symptoms, is not severe and does not require treatment, being identified only during routine examination when the doctor hears a different sound when performing heart auscultation;
- Moderate mitral regurgitation, which causes nonspecific symptoms that are not severe, such as tiredness, for example, and immediate treatment is not necessary. In these cases, the doctor only listens to the patient's heart and prescribes tests, such as echocardiography or chest X-rays to observe the mitral valve and check if the mitral regurgitation has worsened;
- Severe mitral regurgitation, in which there is shortness of breath, coughing and swelling of the feet and ankles, with the use of medication or surgery to correct or replace the valve depending on the patient's age being normally recommended by the doctor;
- Acute mitral regurgitation, which usually happens due to rupture of the heart muscle due to an acute myocardial infarction or infective endocarditis, for example. In that case surgery may be recommended to repair or replace the valve;
- Chronic mitral insufficiency, which usually happens as a result of rheumatic diseases, mitral valve prolapse, calcification of the mitral valve itself or congenital valve deficiency. This type of failure is progressive and should be treated with medication or surgery.
According to the type of insufficiency, the cardiologist is able to define the best type of treatment and, thus, avoid complications and improve the person's quality of life.