mitral_regurgitation_flashcards
What is the definition of Mitral Regurgitation (MR)?
Mitral Regurgitation is the backflow of blood from the left ventricle to the left atrium during systole, due to incomplete closure of the mitral valve.
What is the pathophysiology of chronic MR?
In chronic MR, the left atrium and ventricle gradually dilate to handle the increased volume, leading to eccentric hypertrophy and, eventually, ventricular dysfunction.
What is the pathophysiology of acute MR?
Acute MR presents with sudden volume overload in the left atrium, leading to increased pressure, pulmonary edema, and severe dyspnea due to lack of compensatory dilation.
What is the epidemiology of Mitral Regurgitation?
MR is common, particularly in older adults, with a prevalence of around 2% in the general population. Primary MR often results from degenerative disease, while secondary MR is due to left ventricular dysfunction.
What are the common symptoms of chronic MR?
Common symptoms of chronic MR include dyspnea on exertion, fatigue, decreased exercise tolerance, and orthopnea.
What symptoms indicate acute MR?
Acute MR typically presents with sudden severe dyspnea, fatigue, and signs of acute heart failure.
What are the main risk factors for MR?
Main risk factors include mitral valve prolapse, rheumatic heart disease, prior myocardial infarction, left ventricular dysfunction, and infective endocarditis.
What are characteristic findings on examination in MR?
Characteristic findings include a holosystolic murmur best heard at the apex radiating to the axilla, an S3 sound indicating increased filling pressures, and a displaced apical impulse in chronic MR.
What bedside investigations are used for MR?
ECG may show left atrial enlargement, atrial fibrillation, or left ventricular hypertrophy in MR patients.
What blood marker may be elevated in MR with heart failure?
BNP may be elevated in MR patients with heart failure, indicating increased cardiac strain.
What is the primary imaging tool for diagnosing MR?
Transthoracic Echocardiography (TTE) is essential for diagnosing MR, assessing the severity of regurgitation, and evaluating ventricular function.
When is Transesophageal Echocardiography (TEE) used in MR?
TEE is used in MR when TTE is inconclusive, especially in surgical planning or assessing complex valve anatomy.
What lifestyle modifications are recommended for MR?
Lifestyle modifications for MR include salt restriction, exercise monitoring, and smoking cessation to reduce cardiac strain.
What are the medical management options for MR?
Diuretics are used to manage pulmonary congestion; beta-blockers control rate in atrial fibrillation; anticoagulation is necessary for patients with atrial fibrillation to prevent thromboembolism.
When is mitral valve repair preferred over replacement in MR?
Mitral valve repair is preferred over replacement for MR due to better long-term outcomes and preservation of valve function.
