Mitral Regurgitation

Question 1

Define mitral regurgitation and summarise its aetiology and epidemiology.

Answer 1

Retrograde flow from LV to left atrium during systole

Aetiology:
Mitral valve damage or dysfunction:
- Rheumatic heart disease (most common);
- Infective endocarditis;
- Mitral valve prolapse (prolapse of mitral valve leaflets into the left atrium during systole);
- Papillary muscle rupture or dysfunction (secondary to ischaemic heart disease or
cardiomyopathy);
- Chordal rupture and floppy mitral valve associated with connective tissue diseases
(e.g. pseudoxanthoma elasticum, osteogenesis imperfecta, Ehlers–Danlos syndrome, Marfan syndromes, SLE).

Functional mitral regurgitation may be secondary to left ventricular dilation.

Epidemiology: Affects approx. 5% of adults. Mitral valve prolapse is more common in young
females.

Question 2

Describe the history/presenting symptoms of mitral regurgitation

Answer 2

• Acute MR: Present with symptoms of left ventricular failure
• Chronic MR: May be asym
• Mitral valve prolapse