Regurgitation (or a leak) through a valve suggests that the valve either doesn’t close properly, or that it is under increased pressure. For example, patients with lung disease may have high blood pressure in their lungs (known as ‘pulmonary hypertension’), which can put stress on the pulmonary and tricuspid valves, leading to regurgitation when these valves close. Likewise, valves which are abnormally formed or have developed a structural problem (e.g. mitral valve prolapse), will also leak when they close, even if the pressure in the heart is normal. As mentioned above, the degree of valvular regurgitation ranges from trace or trivial (this is a normal finding), to mild, moderate or severe. Whilst our sonographers will be able to give you a visual approximation of any regurgitation on conclusion of your scan, the precise quantification of regurgitation requires detailed calculations and image processing, which take place in the hours following your test. As such, your draft scan report may suggest that one of your valves has moderate regurgitation on visual inspection, and yet – after detailed analysis – your final report may clarify that the regurgitation is in fact only mild, and vice versa.
Mild regurgitation is often in keeping with the normal ‘wear and tear’ of the heart, and may not necessarily progress to a more serious problem. Moderate regurgitation – especially of the aortic or mitral valves – needs careful observation (we are happy to provide this service however follow-up scans may also be available through the NHS). Severe regurgitation is likely to cause unpleasant symptoms, and needs referral to a specialist for further investigation and, if necessary, valve replacement.
Eccentric regurgitation, in which the leak through the valve is at an acute angle, suggests a structural problem in the valve causing abnormal closure (e.g. mitral valve prolapse). Eccentric regurgitation can be difficult to quantify even following detailed analysis, and if it is causing symptoms, this may require specialist follow-up for consideration of an internal echo scan (a transoesophageal echo).