Mitral Regurgitaion

Question 1

Define mitral regurgitation

Answer 1

Retrograde flow of blood from LV -> LA during systole

Question 2

What are the causes/risk factors of mitral regurgitation?

Answer 2

• Rheumatic heart disease
• Infective endocarditis
• Mitral valve prolapse
• Papillary muscle rupture (secondary to IHD or
cardiomyopathy)
• Connective tissue diseases e.g. Marfan’s
• secondary to LV dilation

Question 3

What are the symptoms of mitral regurgitation?

Answer 3

Symptoms of LV failure
• SOBOE
• ↓ exercise tolerance
• Fatigue

Question 4

What are the signs of mitral regurgitation?

Answer 4

• Pansystolic murmur at apex radiating to axilla
• Soft S1, S3 may be present
• Displaced apex beat
• Irregularly irregular pulse – AF
• Signs of LV failure

Mitral valve prolapse
• Mid-systolic click
• Late systolic murmur
• Palpitations

Question 5

What are the investigations for mitral regurgitation?

Answer 5

• transthoracic echo - presence and severity of MR; other structural and flow abnormalities
• ECG - may show underlying arrythmia or prior infarction