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Mitral Regurgitation

Yongkasem Vorasettakarnkij, MSc, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Disorder of mitral valve (MV) closure, either primary, secondary (functional), or mixed, resulting in a backflow of the left ventricular (LV) stroke volume into the left atrium (LA);...

DIAGNOSIS

HISTORY

  • Associated conditions: RHD, prior MI, connective tissue disorder

  • Acute MR; Sudden onset of dyspnea, Orthopnea, paroxysmal nocturnal dyspnea

  • Chronic MR Exertional dyspnea, fatigue Palpit...

TREATMENT

MEDICATION

  • Acute, severe MR

    • Medical therapy has a limited role and is aimed to stabilize hemodynamics preoperatively.

    • Vasodilators (nitroprusside, nicardipine): to improve hemodynamic compensat...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Chronic MR with new-onset or changing symptoms: TTE 
Chronic MR: asymptomatic patients with normal LV function 
  • Mild MR with normal LV size and no pulmonary hyperte...

REFERENCES

1
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Pra...

CODES

ICD10

  • I34.0 Nonrheumatic mitral (valve) insufficiency

  • I05.1 Rheumatic mitral insufficiency

  • Q23.3 Congenital mitral insufficiency

SNOMED

  • 48724000 Mitral valve regurgitation (disorder)

  • 31085000 Rheumati...

CLINICAL PEARLS

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 primary MR is usually managed with MV ...

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