Mitral regurgitation
Informed by recognized medical guidance
Overview
Mitral regurgitation is a heart valve problem. The mitral valve sits between two chambers on the left side of your heart. Normally, it closes tightly to stop blood from flowing backward. In mitral regurgitation, the valve doesn't close all the way, so some blood leaks backward into the upper chamber. This makes your heart work harder and may cause symptoms over time.
Key facts
- It is one of the most common heart valve problems.
- It can be mild or severe, and many people with mild cases have no symptoms.
- Treatment depends on how severe it is and what is causing it.
Yes, mitral regurgitation is fairly common, especially as people get older. Many people have a mild form without knowing it.
It can affect people of all ages. It is more common in older adults. Some people are born with it, but it often develops later in life due to other heart conditions.
Symptoms
- Sudden, severe shortness of breath that does not improve
- Chest pain or pressure that lasts more than a few minutes
- Fainting or near fainting
- Coughing up pink or frothy phlegm
- ⚠New or worsening shortness of breath that interferes with daily activities
- ⚠Heart palpitations that are new, fast, or irregular
- ⚠Swelling in your legs or belly that comes on suddenly or gets worse
- ⚠Unexplained weight gain of 2–3 pounds in a day or 5 pounds in a week (can be fluid buildup)
Common symptoms
- Shortness of breath, especially when lying down or during activity
- Feeling tired or weak
- Heart palpitations (feeling like your heart is pounding or skipping a beat)
- Swelling in your feet, ankles, or legs
- A dry cough, especially at night
Symptoms in children
- Poor feeding or getting tired quickly during feeding
- Slow weight gain or growth
- Breathing fast or having trouble breathing
- Frequent chest infections
Symptoms in older adults
- Fatigue and weakness that gets worse with activity
- Shortness of breath with mild exertion
- Irregular heartbeat (atrial fibrillation)
- Swelling in the legs or belly
Causes
Main causes
- Mitral valve prolapse (when the valve flaps bulge backward)
- Enlargement of the heart (cardiomyopathy) that stretches the valve opening
- Damage from a heart attack
- Infection of the heart valve (endocarditis)
- Rheumatic fever (a complication from untreated strep throat)
- Age-related wear and tear of the valve
- Being born with an abnormal mitral valve
Risk factors
- Older age (over 65)
- High blood pressure
- History of heart attack or heart disease
- Previous heart infection
- Family history of mitral valve problems
- Certain connective tissue disorders (like Marfan syndrome)
When to see a doctor
See a doctor urgently if:
- If you have sudden, severe shortness of breath or chest pain – call your local emergency number immediately
- If you faint or nearly faint
- If you have a fast or irregular heartbeat that does not go away
Book a routine appointment if:
- If you have mild symptoms like tiredness or occasional shortness of breath
- If you have a heart murmur (your doctor heard it during a check-up)
- If you have a family history of heart valve problems and want to know your risk
Diagnosis
Your doctor will start by asking about your symptoms and listening to your heart with a stethoscope. A heart murmur (a whooshing sound) is often the first sign. If they suspect mitral regurgitation, they will refer you for tests.
Tests that may be done
- Echocardiogram (heart ultrasound) – this is the main test to see how well your valve works and measure the leak
- Electrocardiogram (ECG) – to check your heart's rhythm
- Chest X-ray – to see the size and shape of your heart
- Exercise test (stress test) – to see how your heart handles activity
- Cardiac MRI – in some cases, for more detailed images
What to expect at your appointment
If you are diagnosed with mitral regurgitation, your doctor will explain how severe it is and what that means. You may have regular follow-up appointments and repeat echocardiograms to monitor it. Many people do not need treatment right away.
Treatment
Treatment depends on how severe the leak is, whether you have symptoms, and what is causing it. Mild cases often just need regular monitoring. More severe cases may need medicines or surgery to repair or replace the valve.
Self-care at home
- Keep all follow-up appointments with your doctor or cardiologist
- Tell your doctor about any new or worsening symptoms
- Take care of your teeth and gums (good dental hygiene helps prevent heart valve infections)
- Before dental procedures, ask your doctor if you need antibiotics to prevent infection (this is not routinely recommended in the UK, but check with your healthcare team)
Medical treatments
Medicines cannot fix the valve leak, but they can help manage symptoms. Your doctor may prescribe medicines to help reduce fluid buildup, lower blood pressure, or control an irregular heartbeat. Always take medicines exactly as prescribed and never change the dose without talking to your doctor.
When is surgery considered?
If the mitral regurgitation is severe and causing symptoms or affecting your heart function, surgery to repair or replace the valve may be recommended. Valve repair is often preferred over replacement. The decision depends on your overall health and the structure of your valve.
Living with this condition
If your mitral regurgitation is mild, you can likely live a normal life with no restrictions. If it is moderate or severe, you may need to pace yourself and avoid very strenuous activities. Listen to your body and rest when you need to.
Lifestyle tips
- Stay physically active at a level that feels comfortable – walking, swimming, and cycling are often good choices
- Avoid heavy lifting or straining
- Reduce salt in your diet to help control fluid retention
- Limit alcohol and avoid smoking
- Manage stress with relaxation techniques like deep breathing or gentle yoga
Diet and exercise
A heart-healthy diet is important: lots of fruits, vegetables, whole grains, lean protein, and healthy fats. Limit processed foods, sugary drinks, and foods high in salt. Exercise regularly but check with your doctor before starting a new exercise program, especially if you have symptoms or a leak that is more than mild.
Mental health and emotional wellbeing
Living with a heart condition can cause worry or anxiety. It is normal to feel this way. Talking to family, friends, or a counselor can help. If you feel overwhelmed, let your doctor know. They can connect you with support services.
Prevention
Many cases of mitral regurgitation cannot be prevented, especially those due to aging or genetics. However, you can reduce your risk of heart disease by keeping your blood pressure under control, eating a healthy diet, exercising, not smoking, and getting regular check-ups. Treating strep throat promptly can prevent rheumatic fever, which can damage heart valves.
Vaccines
NHS recommends the flu vaccine and the pneumococcal vaccine for people with heart conditions. Ask your doctor if these are right for you.
Screening programmes
Screening is not routine for everyone. If you have a family history of mitral valve problems or a connective tissue disorder, your doctor may suggest an echocardiogram to check your valve.
Complications
If left untreated
- Heart failure (the heart cannot pump blood as well as it should)
- Atrial fibrillation (an irregular and often fast heart rhythm)
- Pulmonary hypertension (high blood pressure in the arteries of the lungs)
- Increased risk of infective endocarditis (a serious heart valve infection)
Long-term outlook
With regular monitoring and appropriate treatment, most people with mitral regurgitation do very well. Many live full, active lives. If your condition is more severe, modern treatments including minimally invasive repair have excellent outcomes. Your doctor will work with you to choose the best plan for your individual situation.
Find support
International organisations
Local organisations
- Your local health service (NHS or equivalent) · Check your local health service website for heart valve information
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 9, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.