Disorder of mitral valve (MV) closure, either primary or secondary (functional), resulting in a backflow of the left ventricular (LV) stroke volume into the left atrium (LA); uncompe...
Associated conditions: RHD, prior MI, connective tissue disorder
Acute MR
Sudden onset of dyspnea
Orthopnea, paroxysmal nocturnal dyspnea
Chronic MR
Exertional dyspnea, fatigue
Palpitation:...
Acute, severe MR
Medical therapy has a limited role and is aimed to stabilize hemodynamics preoperatively.
Vasodilators (nitroprusside, nicardipine): to improve hemodynamic compensat...
Mild MR with normal LV size and function and no pulmonary hypertension: annual clinical evaluation and TTE every 3 to 5 years
Moderate MR:...
Acker MA, Parides MK, Perrault LP, et al; for Cardiothoracic Surgical Trials Network. Mitral-valve repair versus replacement for severe ischemic mitral regurgitation. N Engl J Med. ...
I34.0 Nonrheumatic mitral (valve) insufficiency
I05.1 Rheumatic mitral insufficiency
Q23.3 Congenital mitral insufficiency
424.0 Mitral valve disorders
394.1 Rheumatic mitral insufficiency
7...
Follow-up for mild to moderate MR: serial exam and/or echo (mild, every 3 to 5 years, moderate 1 to 2 years) unless LV structural changes
Severe MR is usually managed with MV repair.
End...
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<bold>Figure 12.4</bold> Mitral and tricuspid regurgitation. End-diastolic <bold>(A)</bold> and end-systolic <bold>(B)</bold> frames from a left ventriculogram performed in the 30° RAO projection in a patient with normal coronaries and presumptive AIDS cardiomyopathy, showing enlarged end-diastolic and end-systolic volumes, reduced ejection fraction of 38%, and 2+ mitral regurgitation. Note dye to the enlarged left atrial volume; the contrast density method underestimated the severity of regurgitation, shown...
<bold>Figure 12.4</bold> Mitral and tricuspid regurgitation. End-diastolic <bold>(A)</bold> and end-systolic <b...
<bold><italic>FIGURE 11.56.</bold></bold> Parasternal long-axis view recorded in a patient with a dilated cardiomyopathy and apical displacement of the papillary muscles, leading to functional mitral regurgitation. Note the dilation of the left ventricle (<italic>LV</bold>) and left atrium (<italic>LA</bold>). This frame was recorded in mid-systole. Because of the displacement of the papillary muscles, the mitral leaflets are tethered apically and cannot coapt along a normal zone. The mitral valve is attempting to coap...
<bold><italic>FIGURE 11.56.</bold></bold> Parasternal long-axis view recorded in a patient with a dilated cardiom...