Mitral Regurgitation

Question 1

Define Mitral Regurgitation

Answer 1

Backflow of blood through the mitral valve in systole

Question 2

Aetiology of Mitral Regurgitation

Answer 2

Infective endocarditis
LV dilation - functional (myocarditis/ischaemia)
Calcification
Rheumatic fever
Ischaemic papillary muscle dysfunction or rupture
Mitral valve prolapse
Connective tissue - Marfan’s, Ehlers-Danlos
Cardiomyopathy

Question 3

Symptoms of Mitral Regurgitation

Answer 3

Dyspnoea (esp, on exertion)
Fatigue
Palpitations
Oedema
Symptoms of causative factors
Orthopnoea
PND
Diaphoresis

Question 4

Signs of Mitral Regurgitation on examination

Answer 4

Pansystolic murmur over mitral area, radiates to the axilla (left lateral position)
AF
Displaced, hyper dynamic apex beat
Soft S1, split S2

Question 5

Investigations for Mitral Regurgitation

Answer 5

Echo: presence + severity of MR

ECG: AF, P-mitrale (bifid P wave)
CXR: Big LA and LV, mitral valve calcification, pulmonary oedema