Mitral Valve Regurgitation

Today was my first Herceptin only infusion. You may remember that late last month I had an echocardiogram to check my heart. Today, the oncologist told me my numbers were good but that I did have mild regurgitation. Mitral valve regurgitation — or mitral regurgitation — happens when your heart's mitral valve doesn't close tightly, which allows blood to flow backward in your heart. The mitral valve is located between your heart's two left chambers, and allows blood to flow forward through your heart during a normal heartbeat. Mitral valve regurgitation is also called mitral insufficiency or mitral incompetence. I was shocked to learn this but he didn't seem very concerned because for mild cases, treatment may not be necessary. He plans to monitor it but feels it is ok. When mild, mitral valve regurgitation may not progress and never pose a serious threat to your health. I asked if this was caused by the Herceptin, but I didn't get an answer.

When working properly, heart valves open and close fully. In mitral valve regurgitation, the mitral valve doesn't close tightly. So, with each heartbeat, some blood from the left ventricle flows backward into the left atrium, instead of forward into the aorta. Regurgitation refers to this backflow of blood through the heart valve. People who take ergotamine and similar medicines for migraines and those who took pergolide (now removed from the market) have an increased risk of mitral regurgitation. Similar problems were noted with the appetite suppressants fenfluramine and dexfenfluramine, which are no longer sold. Also, by middle age, many people have some mitral valve regurgitation caused by natural deterioration of the valve. However, mitral valve regurgitation causes symptoms in only a small percentage of older adults. Boy, with cancer the fun just never ends!

Recommendations for improving your quality of life if you have mitral valve regurgitation:

• Check your blood pressure regularly. Control of high blood pressure is important if you have mitral valve regurgitation.
• Eat a heart-healthy diet. Food doesn't directly affect mitral valve regurgitation. However, developing coronary artery disease — blockages of arteries that feed your heart muscle — may lead to heart attacks with further weakening of the heart muscle. To follow a heart-healthy diet, eat low-fat foods and check your cholesterol levels regularly.
• Maintain a healthy weight. Excess weight may make you short of breath and may complicate heart surgery if you ever need it. Keep your weight within a range recommended by your doctor.
• Cut back on caffeine. Irregular heartbeats (arrhythmias) may occur in people with mitral valve regurgitation. Arrhythmias may worsen if you consume caffeine.
• Cut back on alcohol. Heavy alcohol consumption can cause arrhythmias and can make your symptoms worse. Excessive alcohol consumption can also cause cardiomyopathy, a condition of weakened heart muscle that often leads to mitral regurgitation.
• Exercise. Physical activity helps to keep your body fit and may also help you to recover faster if you ever need heart surgery. Don't stop exercising if you've received a diagnosis of mitral valve regurgitation.
• See your doctor regularly. Establish a regular evaluation schedule with your cardiologist or primary care provider.