Mitral Regurgitation

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Presentation :

• Acute Regurgitation:
  • Abrupt onset of dyspnea, pulmonary edema, or cardiogenic shock
  • Murmur may be short or absent

Pathophysiology :

• Acute MR most often occurs in patients with chordae tendineae rupture
• MVP is the most common cause of significant MR, though most patients with prolapse have either minimal or no MR

Diagnostic Testing:

Treatment :

• Acute MR:
  • Urgent surgical repair
  • Nitroprusside
  • intra-aortic balloon pump
• Chronic MR
  • Surgical repair if:
    • Symptomatic
    • Asymptomatic patients with EF ≤60% and/or LV end-systolic diameter ≥40 mm
      • If not a surgical candidates, can use transcatheter mitral valve repair with a clip (MitraClip)
  • If 2/2 structural disease (ventricular dilation) with valve annulus dilation, treat with GDMT for ventricular dysfunction.

Prognosis:

References: