What to expect after a mitral regurgitation diagnosis
By ShareMD Connect
Mitral regurgitation is a common but serious heart disease diagnosis. Early treatment and management of the disease can be key in maintaining a good quality of life and preventing heart failure.
If left untreated, severe mitral regurgitation can initiate a series of bad events. Research has found that in those with severe, untreated mitral regurgitation there was a 57% chance of dying within one year as a result of heart failure.
Some people with mild mitral regurgitation don’t have any symptoms. But for others, symptoms can include:
- Heart palpitations or feelings of a fluttering heart or skipped heart beats
- Shortness of breath
- Dizziness
- Extreme fatigue or weakness
- Trouble exercising because you’re getting winded easily
- Swelling, especially in the legs and feet
The good news is that with a timely diagnosis and ongoing management, most patients can continue or resume most, if not all, regular activities.
A lot of the time after receiving a life-changing diagnosis, you may leave the doctor’s office thinking you have a handle on your disease, only to get home and realize that you don’t really know what to expect next. That’s okay!
Below is a list of common questions and answers to reference when you’re left wondering, “what comes next?” after a mitral regurgitation diagnosis.
Do I need to see a specialist?
Yes. Even if your doctor hasn't recommended one, it's essential to consult a cardiologist. If you have moderate or severe mitral regurgitation, you should be evaluated by a multidisciplinary heart valve team.
In fact, the American Heart Association Guidelines advise that people with severe mitral regurgitation, regardless of if they have symptoms or not, be referred to a heart valve center and considered for a valve repair.
Your treatment options will depend on many factors that require an in-depth analysis, but a heart valve center has more expertise in treating mitral regurgitation. The surgeons will be qualified to perform both minimally invasive and open heart procedures and the cardiologists will be up-to-date on the latest medication options. They may also have additional testing capabilities to make sure your disease is being monitored properly.
Do I have to go to the heart valve center my doctor referred me to?
No. You can seek advice from relatives, close friends, or other medical providers, but it's essential to investigate the heart valve center you're considering.
There is a set of standards defined by the Mitral Foundation and the American Heart Association. This is a good starting point to gather information about heart valve centers near you.
As you're going through this selection process, remember that selecting a heart valve team covered by your insurance plan may be necessary if you want to maximize your benefits and minimize out-of-pocket costs.
Will there be many more tests? And if so, are they necessary?
Yes.
Mitral regurgitation is often diagnosed during a physical exam when your doctor hears a murmur through the stethoscope. To confirm the diagnosis, you'll probably be sent for a transthoracic echocardiogram (or TTE) and possibly other tests, such as an EKG and chest X-ray.
If your mitral regurgitation is just mild and you aren't experiencing any symptoms, you will likely need to get serial echocardiograms for monitoring, because it can worsen with time.
If your mitral regurgitation is moderate or severe, further testing is often required to help figure out the cause of it- which helps the team determine the best way to treat it. This may include a CT scan, cardiac catheterization, or stress testing.
Other tests that are sometimes ordered in pre-operative planning stages include a transesophageal echocardiogram (TEE), pulmonary function testing (or PFT's) to evaluate your lung function, and a carotid ultrasound.
The purpose of all these tests is to understand how severe your condition is, look at the anatomy of your heart, and make sure you don’t have other undiagnosed health issues that need to be properly treated prior to going into heart surgery. Once all of the testing is reviewed by the heart valve team, your specific treatment options can be presented to you so you can make a decision together.
How do I manage my medication?
For people with mild to moderate secondary (or functional) mitral regurgitation, a medication management plan called Guideline Directed Medical Therapy (GDMT) may be the treatment plan that you start with. The goal of medication treatment is to manage your symptoms and prevent your heart from reshaping itself and causing further damage.
You must strictly follow your doctor's and pharmacist's medication instructions, even if you don’t fell like they’re doing anything. Call your doctor immediately if you have side effects, have questions about your medicine, or if something doesn't seem right. Your cardiologist will keep you on the path to recovery and alter your medication as necessary.
Never miss doses, adjust your dosage, or stop taking your medicine without speaking with your doctor. It may be tempting to take less medicine or stop altogether when you're no longer experiencing symptoms, but you should always consult your doctor before making any modifications. Your medication will not work as intended if it is taken incorrectly.
I don't feel that bad - do I need to worry about this?
Yes.
If left untreated, severe mitral regurgitation can initiate a series of bad events leading to heart failure and death, with a 57% chance of dying within one year.
A lot of patients even say that they hadn’t realized how bad their symptoms were until they were gone,
Mitral regurgitation will - over time - damage your heart. It can actually reshape the organ and cause heart failure.
Even if your condition is mild, proper disease management gives you a much better chance at a higher quality of life and has the potential to prolong your lifespan.
Although mitral regurgitation is a serious disease that requires careful monitoring, with the proper treatment and the right provider team, you can manage your disease and get back to doing the things you love.