Mitral Regurgitation

Question 1

PATHOLOGY: MITRAL REGURGITATION

Answer 1

1. Regurg into let atrium = increased left atrium pressure
2. = increased atrial dilation
3. =increase pulmonary pressure and pulmonary oedema
4. Also left ventricular hypertrophy

Question 2

AETIOLOGY: MITRAL REGURGITATION

Answer 2

• Rheumatic heart disease
• Mitral valve prolapse
• IHD
• Post MI
• Hypertrophic cardiomyopathy
• Degenerative calcification
• Infective endocarditis
• Connective tissue disorders

Question 3

SYMPTOMS: MITRAL REGURGITATION

Answer 3

• SOB
• Fatigue
• Orthopnoea
• Right sided HF

Question 4

CLINICAL SIGNS: MITRAL REGURGITATION

Answer 4

• Jerky pulse
• Soft S1
• Displaced apex beat
• Apical thrill
• S3
• Pansystolic murmur
• Pulmonary oedema

Question 5

INVESTIGATIONS: MITRAL REGURGITATION

Answer 5

1. ECG
   * Broad P wave (left atrium enlargement)
2. CXR
   * Enlarged left atrium and ventricle
3. Echo w/ doppler
   * Can see ejection into left atrium

Question 6

MANAGEMENT: MITRAL REGURGITATION

Answer 6

• 1. Conservative*
• Seriel echo if only mild
• 2. Medical*
• Treat symptoms (diuretics, ACEi, digoxin)
• 3. Surgical*
• Mitral valve replacement