Mitral regurgitation - acute

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Mitral regurgitation - acute

• rapid breathing
• shortness of breath that increases when lying flat (orthopnea). In severe acute mitral regurgitation, shortness of breath is due the backflow of blood into the lungs.
• sensation of feeling the heart beat (palpitations)
• chest pain -- unrelated to coronary artery diseese or a heart attack
• cough

Palpation may show thrill (vibration) over the heart. A stethoscope may reveal a distinctive murmur in the heart. However, this murmur may be absent in some cases of acute mitral regurgitation. If fluid backs up into the lungs, there may be crackles heard in the lungs. Blood pressure is usually normal. Billowing of the mitral valve and/or regurgitation of blood may be seen on:

• echocardiogram -- an ultrasound examination of the heart
• color flow Doppler examination
• transesophageal echocardiogram (TEE)
• cardiac catheterization

A chest X-ray may also show fluid in the lungs or prominent pulmonary veins. Swan-Ganz (right heart catheterization) pressure readings will record a marked elevation of left atrial pressure. An ECG usually shows a normal sinus rhythm but may show arrhythmias (abnormal heart rhythms) such as atrial fibrillation. Atrial fibrillation is more common in chronic mitral regurgitation, however. Other tests may include a chest MRI scan, radionuclide scans, or a CT scan of the chest.

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