How is mitral regurgitation diagnosed?
There are many diagnostic tests that have abnormal results in the presence of mitral regurgitation. These tests suggest the diagnosis of mitral regurgitation and may indicate to the physician that further testing is warranted. For instance, the electrocardiogram (ECG) in long standing mitral regurgitation may show evidence of left atrial enlargement and left
ventricular hypertrophy. Atrial fibrillation may also be noted on the ECG in individuals with chronic mitral regurgitation. The ECG may not show any of these finding in the setting of acute mitral regurgitation.
The quantification of mitral regurgitation usually employs imaging studies such as echocardiography or magnetic resonance angiography of the heart.
Chest X-ray. With an X-ray of your chest, your doctor can see the size and shape of your heart to determine whether the left ventricle is enlarged. A chest X-ray also allows your doctor to evaluate your lungs. Mitral regurgitation may result in blood backing up into your lungs, which causes congestion that's visible on an X-ray.
Electrocardiogram (ECG). In this test, patches with wires (electrodes) are attached to your skin to measure the electrical impulses given off by your heart. Impulses are recorded as waves displayed on a monitor or printed on paper. An ECG gives information about heart rhythm and, indirectly, heart size. With mitral regurgitation, the left ventricle may be enlarged and you may have heart rhythm irregularities (arrhythmias).
Holter monitor. A Holter monitor is a portable device that you wear to record a continuous ECG, usually for 24 to 72 hours. Holter monitoring is used to detect intermittent heart rhythm irregularities that may be associated with mitral regurgitation.
Echocardiogram. This test uses sound waves to produce an image of your heart. In an echocardiogram, sound waves are directed at your heart from a wand-like device (transducer) held on your chest. The sound waves bounce off your heart and are reflected back through the chest wall and processed electronically to provide video images of your heart in motion. An echocardiogram helps your doctor get a close look at the mitral valve and how well it is - or isn't - working. A specific type of echocardiogram, a Doppler echocardiogram, may be used. It allows precise measurements of the volume of blood flowing backward through the mitral valve.
Transesophageal echocardiogram. This type of echocardiogram allows an even closer look at the mitral valve. The esophagus, the tube that runs from your throat to your stomach, lies close to your heart. In a traditional echocardiogram, a transducer is moved across your chest. In a transesophageal echocardiogram, a small transducer attached to the end of a tube is inserted down the esophagus. Because the esophagus lies close to your heart, having the transducer there provides a clearer picture of the mitral valve and blood flow through it.
Exercise tests. Various exercise tests can help measure your tolerance for activity and check your heart's response to exertion (exercise).
Cardiac catheterization. In this procedure, a doctor threads a thin tube (catheter) through a blood vessel in your arm or groin into your heart. The catheter is used to deliver dye into the heart chambers and the blood vessels of your heart. The dye, appearing on X-ray images as it moves through your heart, gives your doctors detailed information about your heart and heart valves. Some catheters used in cardiac catheterization have miniature devices (sensors) at the tips that can measure pressure within heart chambers, such as the left ventricle. |
