mitral regurgitation

Question 1

what is mitral regurgitation?

Answer 1

retrograde flow of blood from left ventricle to left atrium during systole

Question 2

epidemiology of mitral regurgitation?

Answer 2

• second most common murmur

- more common in females

Question 3

risk factors of mitral regurgitation?

Answer 3

o	Females 
o	Lower body mass 
o	Age 
o	Renal dysfunction 
o	Prior mitral stenosis

Question 4

what are the causes of mitral regurgitation?

Answer 4

o Rheumatic heart disease (MOST COMMON in the world)
o Following CAD or post-MI
o Infective endocarditis
o Mitral valve prolapse

o connective tissue disease

Question 5

how does mitral regurgitation present?

Answer 5

o	Normally asymptomatic  
o	Left heart failure: 
-	dyspnoea 
-	fatigue 
-	oedema 
o	AF: palpitations 
o	Fatigue

Question 6

how would you describe a mitral regurgitation murmur?

Answer 6

•Pansystolic murmur

o High pitched and blowing in character

Question 7

where is a mitral regurgitation murmur best heard?

Answer 7

• Heard best at the apex radiating into the axilla

Question 8

what are other features of a mitral regurgitation murmur?

Answer 8

• S1 may be quiet as a result of incomplete closure of the valve
• Severe MR can cause a split S2
• Third heart sound present

Question 9

what is the best investigation for a mitral regurgitation murmur?

Answer 9

• Echocardiography

o Allows assessment of LV ejection fraction and end-systolic dimension