Mitral Regurgitation Flashcards
What is mitral regurgitation also known as?
Mitral insufficiency
What is mitral regurgitation due to?
An incompetent mitral valve
What happens during mitral regurgitation?
Blood leaks back through the mitral valve during systolic contraction of the left ventricle
Where is the mitral valve located?
Between the left atrium and ventricle
During which stage of contraction does the blood leak with mitral regurgitation?
During systole
How is the mitral regurgitation murmur described?
Pan-systolic, high pitched “whistling” murmur
Where does the murmur caused by mitral regurgitation radiate?
The left axilla
How can the other heart sounds be affected during mitral regurgitation?
S1 may be quiet
Widely split S2 (third heart sound)
Why might S1 be quiet in someone with mitral regurgitation?
Due to incomplete closure of the valve
What investigations might you do if someone presents with suspected mitral regurgitation?
ECG
Chest x-ray
Echocardiogram
How may someone with mitral regurgitation present clincially?
Usually asmptomatically
What clinical presentations might you see in someone presenting with mitral regurgitation?
Fatigue
Shortness of breath
Oedema.
What might you see on an ECG of someone presenting with mitral regurgitation?
A broad P wave
What does a broad p wave indicate?
Atrial enlargement
What might you see on a chest x-ray of someone presenting with mitral regurgitation?
Cardiomegaly- enlarged left atria and ventricle
What is the use of an echocardiogram in the assessment of mitral regurgitation?
Essential for diagnosis and to assess severity
What are the risk factors of mitral regurgitation?
- Female sex
- Lower body mass
- Age
- Renal dysfunction
- Prior myocardial infarction
- Prior mitral stenosis or valve prolapse
- Collagen disorders
Which collagen disorders increase the risk of mitral regurgitation?
Marfan’s Syndrome
Ehlers-Danlos syndrome
What are the main causes of mitral regurgitation?
Following coronary artery disease or post-MI
Mitral valve prolapse
Infective endocarditis
Rheumatic fever
Congenital
How does coronary artery disease or post-MI cause mitral regurgitation?
Damage to surrounding structures
How does mitral valve prolapse cause mitral regurgitation?
Leaflets of the mitral valve is deformed so the valve does not close properly and allows for backflow.
How does infective endocarditis cause mitral regurgitation?
Vegetations from the organisms colonising the heart grow on the mitral valve, it is prevented from closing properly
Where does rheumatic fever typically cause mitral regurgitation?
Underdeveloped countries
What are the symptoms of mitral regurgitation due to?
Pulmonary oedema
or
Left heart failure
