Mitral Regurgitation

Question 1

What are the causes are mitral regurgitation?

Answer 1

Papillary muscle dysfunction (post-MI), dilated cardiomyopathy, rheumatic fever, infective endocarditis, congenital, connective tissue disorder e.g. Marfan’s, mitral valve prolapse, SLE

Question 2

How do patients with mitral regurgitation present?

Answer 2

Sob, fatigue, other left ventricular failure symptoms (orthopnoea, PND)

Question 3

What will be heard on auscultation of patients with mitral regurgitation?

Answer 3

Pansystolic blowing heard loudest at the apex, radiating to the axilla. There may be a quiet 1st heart sound, an obliterated 2nd heart sound and a 3rd heart sound

Question 4

What will the apex beat be like it mitral regurgitation?

Answer 4

Thrusting (volume overload), displaced apex

Question 5

What will be felt on palpation of mitral regurgitation?

Answer 5

Rarely there will be a thrill

Question 6

What will the CXR show in mitral regurgitation?

Answer 6

Cardiomegaly

Question 7

What are the ECG features in mitral regurgitation?

Answer 7

AF, VEBs

Question 8

What is the treatment for mitral regurgitation?

Answer 8

AF treatment and anticoagulation, diuretics, ACEi (HTN worsens MR)