Mitral Regurgitation

Question 1

Pathophysiology

Answer 1

Failure of closure of mitral valve

Question 2

Causes

Answer 2

Valve prolapse
Age related calcifaction
Cordae Tendinae Rupture
Papillary muscle dysfuntion
Rheumatic fever
Infective endocarditis
Marfans/EDS

Question 3

Symptoms

Answer 3

Mostly asymptomatic
Onset of HF Symptoms may occur after 16 yrs
SOB, Odema, Fatigue

Question 4

Examination findings Auscultation

Answer 4

Pan Systolic Blowing murmur, hear loudest in 5th ICS MCL, Radiating to axilla
Reduced S1 sound (Mitral valve doesnt shut completely)

Question 5

Examination findings complications

Answer 5

Bibasal Crackles
Sacral odema
Peripheral odema
Irregularly irregular pulse (AF)

Question 6

Investigations

Answer 6

CXR - Cardiomegaly
ECG - Broad P waves (Atria dilation)
Echo - Diagnosis

Question 7

Treatment

Answer 7

ACEi/ BB to offload prior to surgery
Valve repair/ replacement

Question 8

Indications For Surgery

Answer 8

Symptomatic
Asymptomatic with Mild/Moderate LVD (EF 30-60%)