Mitral Regurgitation

Occurs when blood leaks back through the mitral valve during systole

Aetiology

  • Can be due to a primary valve disorder e.g. infective endocarditis, MI causing valve prolapse, rheumatic fever
  • Can occur secondary to left ventricular dysfunction e.g. from cardiomyopathy, or post-MI

Clinical presentation

Symptoms

  • Dyspnoea
  • Peripheral oedema
  • Fatigue

Signs

  • Pan-systolic murmur best heard at the apex (5th intercostal space in the left midclavicular line)
  • Murmur radiates to the axilla
  • Displaced apex

Investigations

  • CXR
  • ECG
  • Echocardiogram - to confirm diagnosis and assess severity
  • Others if indicated: CMR, coronary angiography

Management

Medical therapy

  • Diuretics
  • ACEi if heart failure develops

Surgery

  • Open heart surgery and valve repair or replacement
  • MitraClip if can’t tolerate open heart surgery