Heart Murmurs & Mitral Regurgitation Stages
February 15, 2022
If your doctor has ever told you that you have a heart murmur, that same doctor may have also said, “but it’s not serious—nothing to worry about.” After all, a heart murmur sounds like a small thing, hardly noticeable. And for many people, it is. Many people have this condition, some for years, without any symptoms.
Still, a heart murmur may be a sign of a leaking heart valve, also called mitral regurgitation (MR). If a heart murmur remains stable, that’s good, but if the condition worsens undetected, it could result in heart failure.
That’s why regular checkups with a doctor are so important for adults with a heart murmur.
“It is difficult to predict when a heart murmur will turn into a compromised valve, but we can monitor and watch to see when the condition worsens,” said George Lolay, MD, FACC, a cardiologist with Indiana Heart Physicians, a Franciscan Physician Network practice in Indianapolis. “Doing so helps us decide when we need to intervene and consider valve surgery or replacement.”
Mitral regurgitation conditions are staged based on symptoms and heart function.
Three Stages Of Mitral Regurgitation
There are three stages of mitral regurgitation:
- Compensated stage
- Transitional stage
- Decompensated stage
Compensated Stage Of Mitral Regurgitation
In the compensated stage of mitral regurgitation, the heart and cardiovascular system have adjusted to the faulty heart valve and continue to function well. Patients rarely report symptoms, and many remain in this stage throughout their lives.
Transitional Stage Of Mitral Regurgitation
During the transitional stage of mitral regurgitation, the heart begins to enlarge, cardiac pressures increase and output drops. It’s not always known why a patient’s heart murmur worsens.
Some patients may experience issues such as shortness of breath when exercising, but some have no additional symptoms. Still, this is the time for intervention, usually heart valve surgery.
“Sometimes patients also develop atrial fibrillation during this stage,” said Dr. Lolay, “which many cardiologists take as a sign that the patient truly is in the transitional stage of mitral regurgitation and should consider surgery to repair or replace the valve in addition to being treated for AFib.”
Decompensated Stage Of Mitral Regurgitation
At the decompensated stage, the heart is greatly taxed and usually becomes enlarged. Patients start to experience more severe symptoms, such as shortness of breath and swelling in the arms or legs.
“This is the stage we want to avoid,” said Dr. Lolay. “At this point, the patient has heart failure, and the heart muscle has been damaged, and not just the valves. Treatment is more difficult and not as successful.”
Monitoring Your Heart Murmur Is Key
While a heart murmur may not present a problem for a patient for many years, it’s important to understand that it should not be ignored. For the best outcomes and timely treatment, you and your doctor should be monitoring your condition.
“It’s important to know at which stage you are,” said Dr. Lolay. “I would recommend to anyone who’s been told he or she has a heart murmur to be tested thoroughly to have a good picture of their heart function.”
Going by symptoms is not enough, he added. “A cardiologist can order tests needed for a second opinion,” he said.
