Mitral Regurgitation

Question 1

Etiology’s of mitral regurgitation:
-Primary
-Secondary

Answer 1

-primary:
• degenerative mitral valve disease
• rheumatic fever
• infective endocarditis
-Secondary:
• CAD or prior MI
• dilated cardiomyopathy

Question 2

Clinical features of acute MR?
- S&S
- auscultation

Answer 2

S&S: Dyspnea, symptoms of left sided HF, S&S of pulmonary edema, cardiogenic shock, palpitations
Ausc: soft, decrescendo murmur; potential S3 heart sound

Question 3

Clinical feature of chronic MR
- S&S
- auscultation

Answer 3

S&S: Dyspnea, dry cough, fatigue, palpitations, symptoms of LSHF (potential of right sided HF)

Ausc: Lateral displacement of the apical impulse, quiet S1
• Holosystolic Murmur: radiates to the left axilla and heard best over the apex (5th intercostal space at the midclavicular line)
^- Intensity can increase due to increasing preload (e.g. leg raise) or after load (e.g. hand grip) due to increased regurgitation

Question 4

What diagnostic tests can be given for MR?

Answer 4

TTE, EKG (biphasic P waves, afib), CXR

Question 5

Treatment for MR?

Answer 5

All patients with MR should undergo surgery for either repair or valve replacement
Otherwise, manage for heart failure