Mitral Regurgitation
Introduction
-Mitral regurgitation (MR) occurs due to the inability of the mitral valve to close adequately to prevent blood from returning back to the left atrium from the left ventricle during systole
-Most common cause is mitral valve prolapse
-Acute: papillary muscle rupture
-Chronic: Rheumatic fever, mitral valve prolapse
Symptoms & Signs
symptoms in proportion to increase in left atrial pressure and pulmonary hypertension
– fatigue, exhaustion, atypical chest pain, progressive dyspnea, congestive heart failure, paroxysmal nocturnal dyspnea, orthopnea, pleural effusion, edema, increased jugular pressure
-A holosystolic murmur best heard at the apex, with radiation to the axilla
-Handgrip exercise increases the intensity of the murmur
Diagnosis
ECG: left atrial abnormality, left ventricular hypertrophy
Chest X-ray: can show LV enlargement, left atrial enlargement, and pulmonary edema
Echocardiography: the diagnostic test of choice; can show mitral valve regurgitation, size of left atrium, left ventricle, pulmonary pressure
Treatment
Medications: Diuretics, ACE inhibitors
Surgical: Mitral valve repair or replacement