Complications Of Mitral Valve Regurgitation

There are several complications of mitral regurgitation (MR). Pulmonary edema is one of the complications that can cause difficulty in breathing. Due to the high pressure in the left atrium fluid is pushed out of the capillaries and it collects in the air sacks causing pulmonary edema. In mitral valve regurgitation due to the regurgitation the pressure in the left atrium is high. This cause increased pressure in the pulmonary veins and arteries giving rise to pulmonary venous and arterial hypertension. Irreversible left ventricular systolic dysfunction and congestive cardiac failure is two other complications which occur due to the remodeling of the left and right ventricles. Infective endocarditis is another complication. The most serious complication is thromboembolism resulting from atrial fibrillation.

The details of mitral valve regurgitation complications:

Pulmonary edema is excess fluid in the lungs which collects in different air sacks and cause difficulty in breathing. It is a complication and might be the first manifestation of your mitral regurgitation (MR). In mitral valve regurgitation proportion of the blood that flow through the mitral valve from the left atrium to the left ventricle backflows back to the left atrium. When this occur for a long time the left atrium enlarges and the pressure of the left atrium increase. This causes increased pressure in the pulmonary veins which pushes the fluid out of the capillary walls to the air sacks. Fluid in the air sacks cause problems to the air flow and air exchange which will manifest as difficulty in breathing.

In mitral valve regurgitation due to the regurgitation the pressure in the left atrium is high. This cause increased pressure in the pulmonary veins. The increased pressure in pulmonary veins causes increase pressure in the pulmonary artery as the artery has to pump the blood harder against the increased pressure. This cause pulmonary venous and arterial hypertension. Development of pulmonary hypertension indicates a bad prognosis and surgical intervention is needed for the mitral valve regurgitation. But surgical intervention may not reverse the pulmonary hypertension.

Since, some amount of blood is regurgitated the stroke volume reduce which reduce the cardiac output. To maintain a normal stroke volume the left ventricle enlarges and remodel itself. The dilatation and the remodeling progress if the mitral valve regurgitation is not treated. With chronic mitral valve regurgitation the progressive remodeling and the chronic stress on the left ventricle wall due to dilatation causes irreversible changes which affects the function of the left ventricle. Ultimately irreversible left ventricular systolic dysfunction occurs.

Initially left heart failure occurs due to the irreversible left ventricular dysfunction. With the development of pulmonary hypertension, the right ventricle pressure increases, remodeling of the right ventricle occurs to pump blood against the high pressure in the pulmonary artery. With time right ventricle dysfunction occur which leads to right heart failure. Right and left heart failure is known as congestive heart failure.

Infective endocarditis (IE) is an infection in the inner lining of the heart due to bacteria that has entered through the blood stream. Heart valves are also part of the inner lining and damaged, calcified, repaired or replaced valves are at high risk of getting IE. It’s quite a rare complication with mitral valve regurgitation but seen more in patients with mitral valve prolapse. Infective endocarditis of the mitral valve is more common than the other valves.

Atrial fibrillation (AF) is not commonly seen in mitral regurgitation (MR) as seen in mitral stenosis, however, it can occur when the atrium is enlarged. With the atrial enlargement the electrophysiology of the left atrium changes which gives rise to AF. Thrombus is formed in the left atrium which can detach and travel through the blood vessels commonly to the brain and cause stroke. This is a life-threatening complication of mitral valve regurgitation.

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