Mitral Regurgitation: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Mitral Regurgitation?
A cardiologist, a heart doctor, usually treats mitral regurgitation. A heart surgeon repairs or replaces the valve when that is needed. A primary care doctor can help find the problem and arrange follow-up. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is mitral regurgitation?
Mitral regurgitation is a disorder in which the mitral valve on the left side of the heart does not close properly. Regurgitation means leaking from a valve that does not close all the way.
The mitral valve sits between the two left chambers of the heart. When it does not close all the way, blood flows backward into the upper chamber, the left atrium, as the lower chamber, the left ventricle, squeezes. This cuts down on the amount of blood that flows to the rest of the body. The heart may need to pump harder, which may lead to congestive heart failure.
Symptoms
Many people have no symptoms. When symptoms occur, they often develop slowly. They may include:
- Cough.
- Feeling tired, worn out, or lightheaded.
- Rapid breathing.
- A pounding or rapid heartbeat. Doctors call a heartbeat you can feel palpitations.
- Shortness of breath that gets worse with activity or when lying down.
- Waking up an hour or so after falling asleep because of trouble breathing.
- Needing to urinate a lot at night.
Causes and who gets it
Mitral regurgitation may begin suddenly. This often happens after a heart attack. When the leak does not go away, it becomes long-term, which doctors call chronic. Many diseases or problems can weaken or damage the valve or the heart tissue around it. You are at risk if you have:
- Coronary heart disease and high blood pressure.
- An enlarged left lower heart chamber, called the left ventricle.
- An infection of the heart valves.
- Mitral valve prolapse, which is when the valve flaps bulge back into the left atrium.
- Rare conditions, such as untreated syphilis or Marfan syndrome.
- Rheumatic heart disease, a complication of untreated strep throat that is becoming less common.
How doctors diagnose it
Your provider listens to your heart and lungs. A distinctive heart murmur, an extra heart sound, or crackles in the lungs may be heard. Tests include an echocardiogram, which is an ultrasound exam of the heart, a CT scan of the heart, or an MRI. A cardiac catheterization, which uses a catheter (a thin tube), may be done if heart function becomes worse.
Treatment
Treatment depends on your symptoms, the condition that caused the leak, how well your heart is working, and whether your heart has become enlarged. Most of the time the condition is mild, so no therapy or restriction is needed.
When symptoms get worse, your provider may prescribe:
- Beta-blockers, ACE inhibitors, or calcium channel blockers.
- Blood thinners to help prevent blood clots in people with atrial fibrillation, an abnormal heart rhythm.
- Medicines that help control uneven or abnormal heartbeats.
- Water pills, called diuretics, to remove extra fluid in the lungs.
A low-sodium diet may help. You may need to limit your activity if symptoms develop.
You may need surgery to repair or replace the valve if heart function is poor, the heart becomes enlarged, or symptoms get worse. Repair can improve symptoms, but sometimes problems return.
Sometimes the valve cannot be repaired and must be replaced with a mechanical or a biological valve. Biological valves are made from animal tissue. They do not require blood thinners, but they do not last as long. Mechanical valves last longer, but need blood-thinning medicine for life.
Some selected people can have clips or a new valve placed through a catheter instead of surgery. Risks of valve replacement include stroke, blood clots, bleeding where the catheters were inserted, and injury to the kidneys or the heart.
When to see a doctor
Contact your provider if your symptoms get worse or do not improve with treatment. If you are being treated for this condition, also call if you develop signs of infection. These include chills, fever, a general ill feeling, headache, and muscle aches.
Call 911 or go to the emergency room if you have severe trouble breathing, chest pain or discomfort that lasts two minutes or more, or you faint.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can do a first evaluation, refer you to a cardiologist, and see you for regular visits to review your symptoms and medicines.
Common questions
How serious is mitral regurgitation?
It depends on the person. The outcome varies, and most of the time the condition is mild. The heart may need to pump harder, which may lead to heart failure. Symptoms can most often be controlled with medicine.
What problems can mitral regurgitation cause?
It can cause abnormal heart rhythms, including atrial fibrillation, and clots that may travel to other areas of the body, such as the lungs or brain. It can also cause infection of the heart valve and heart failure.
Does mitral valve prolapse always cause a leak?
No. Most people who have mitral valve prolapse do not have backflow and never have related symptoms or problems.
How can I lower my risk of a valve infection?
Treat strep infections quickly, avoid unclean injections, and tell your provider and dentist about any history of heart valve disease before treatment. Some people may need antibiotics before dental procedures or surgery.
Sources
- MedlinePlus - Mitral valve regurgitation: MedlinePlus Medical Encyclopedia
- National Heart, Lung, and Blood Institute - Heart Valve Diseases: Treatment
- National Heart, Lung, and Blood Institute - Heart Valve Diseases: Types
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
