Mitral Regurgitation

Question 1

What are the causes of mitral regurgitation? (6)

Answer 1

1. Rhuematic heart disease
2. Infective endocarditis
3. MVP
4. Papillary msucle rupture e.g. post MI
5. Marfan’s
6. SLE

secondary to severe left ventricular dilatation

Question 2

What type of murmur is a mitral regurgitation murmur?

Answer 2

Pansystolic murmur
Best heard at apex
Blowing in nature

Radiates to the axilla

Question 3

What features are associated with mitral regurgitation?

Answer 3

1. 3rd heard sound
2. Thrusting, displaced apex
3. Quiet 1st heart sound
4. Obliterated second heart sound
5. AF

‘Clik’ in mitral valve prolapse prior to the murmur

Question 4

What are the differentials for a mitral regurgitation murmur? (3)

Answer 4

1. VSD - e.g. post mI
2. Tricuspid regurgitation
   - look for pulsatile hepatomegaly
   - look for giant V waves in JVP
3. AS - any systolic murmur