Mitral regurgitation causes: Difference between revisions

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{{Mitral regurgitation}}
{{Mitral regurgitation}}
{{CMG}}; {{AE}} [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]; {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.
{{CMG}}; {{AE}} [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]; {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.; {{M.P}}


==Overview==
==Overview==
Mitral regurgitation is due to either perforation or prolapse of the leaflets, dilation of the mitral annulus or rupture of the papillary muscles or chordae tendineae. The most common cause of mitral regurgitation is [[mitral valve prolapse]] (MVP).  [[Ischemic heart disease]] causes mitral regurgitation by the combination of ischemic dysfunction of the papillary muscles, and the dilatation of the left ventricle.  [[Rheumatic fever]] and [[Marfan's syndrome]] are other typical causes of mitral regurgitation.
The causes of mitral regurgitation (MR) depend on the acuity of the valvular abnormality and the underlying pathological mechanism.  Acute MR occurs when there is sudden disruption of one or more of the components of the mitral valve, such as leaflet perforation, rupture of a chordae tendineae, or rupture of the papillary muscle. The sudden disruption of the mitral valve can be caused by [[infective endocarditis]], degenerative mitral valve disease, or acute [[ST elevation myocardial infarction]].<ref name="pmid24603192">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2014 | volume= 63 | issue= 22 | pages= 2438-88 | pmid=24603192 | doi=10.1016/j.jacc.2014.02.537 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24603192 }} </ref>  Chronic primary MR is most commonly caused by [[mitral valve prolapse]]; other causes include [[rheumatic fever]] and [[Marfan's syndrome]].  Chronic secondary MR results from the dysfunction and dilatation of the left ventricle rather than an intrinsic abnormality in one of the components of the mitral valve and it can be caused by coronary artery disease (ischemic) or any disease causing [[left ventricular dysfunction]] and dilatation (functional).<ref name="pmid21586426">{{cite journal| author=Ciarka A, Van de Veire N| title=Secondary mitral regurgitation: pathophysiology, diagnosis, and treatment. | journal=Heart | year= 2011 | volume= 97 | issue= 12 | pages= 1012-23 | pmid=21586426 | doi=10.1136/hrt.2010.219170 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21586426  }} </ref>


==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.<ref name="pmid246031922">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2014 | volume= 63 | issue= 22 | pages= 2438-88 | pmid=24603192 | doi=10.1016/j.jacc.2014.02.537 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24603192  }}</ref><ref name="pmid215864262">{{cite journal| author=Ciarka A, Van de Veire N| title=Secondary mitral regurgitation: pathophysiology, diagnosis, and treatment. | journal=Heart | year= 2011 | volume= 97 | issue= 12 | pages= 1012-23 | pmid=21586426 | doi=10.1136/hrt.2010.219170 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21586426  }}</ref>
 
*[[Acute coronary syndrome]]
*[[Acute coronary syndrome]]
*[[chest trauma|Blunt or penetrating chest trauma]]
*[[chest trauma|Blunt or penetrating chest trauma]]
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====Chronic Mitral Regurgitation====
====Chronic Mitral Regurgitation====
*[[Congestive heart disease]]
=====Primary Mitral Regurgitation=====
*[[Ischemic heart disease]]
 
*[[Mitral valve prolapse]]
*'''Developed World:''' [[Mitral valve prolapse]] ([[MVP]])
*[[Rheumatic heart disease]]
*'''Developing World:''' [[Rheumatic heart disease]]
 
=====Secondary Mitral Regurgitation=====
* [[Ischemic heart disease]]
* Dilated [[left ventricle]] (due to any cause of [[dilated cardiomyopathy]], including [[aortic insufficiency]], nonischemic dilated [[cardiomyopathy]] and [[noncompaction cardiomyopathy]])


===Causes by Organ System===
===Causes by Organ System===
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|bgcolor="Beige"| [[Cabergoline]], [[dexfenfluramine]], [[ergotamine]], [[fenfluramine]], [[fluoxetine]], [[3,4-methylenedioxymethamphetamine]], [[methysergide]], [[paroxetine]], [[pergolide]], [[phentermine]], [[sertraline]]
|bgcolor="Beige"| [[3,4-Methylenedioxymethamphetamine]], [[cabergoline]], [[dexfenfluramine]], [[ergotamine]], [[fenfluramine]], [[fluoxetine]], [[methysergide]], [[paroxetine]], [[pergolide]], [[phentermine]], [[sertraline]]
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| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Behçet's disease]], [[Ehlers-Danlos syndrome]], [[Marfan's syndrome]], [[osteogenesis imperfecta]], [[polychondritis]], [[rheumatic heart disease]], [[rheumatoid arthritis]], [[Sjögren's syndrome]] , [[systemic lupus erythematosus]], [[temporal arteritis]]
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Behçet's disease]], [[Ehlers-Danlos syndrome]], [[Marfan's syndrome]], [[osteogenesis imperfecta]], [[polychondritis]], [[rheumatic heart disease]], [[rheumatoid arthritis]], [[Sjögren's syndrome]], [[systemic lupus erythematosus]], [[temporal arteritis]]
|-
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*[[3,4-methylenedioxymethamphetamine]]
*[[3,4-methylenedioxymethamphetamine]]
*[[Acute coronary syndrome]]
*[[Acute coronary syndrome]]
*[[Alcoholism]]
*[[Alcoholism]]<ref name="pmid7420729">{{cite journal| author=Koide T, Kato A, Takabatake Y, Iizuka M, Uchida Y, Ozeki K et al.| title=Variable prognosis in congestive cardiomyopathy. Role of left ventricular function, alcoholism, and pulmonary thrombosis. | journal=Jpn Heart J | year= 1980 | volume= 21 | issue= 4 | pages= 451-63 | pmid=7420729 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7420729 }} </ref>
*[[Ankylosing spondylitis]]
*[[Ankylosing spondylitis]]
*[[Antiphospholipid syndrome]]<ref name="pmid23743123">{{cite journal| author=Scantlebury DC, Nkomo VT, Enriquez-Sarano M| title=Antiphospholipid syndrome and recurrent thrombotic valve disease. | journal=J Am Coll Cardiol | year= 2013 | volume= 61 | issue= 23 | pages= e177 | pmid=23743123 | doi=10.1016/j.jacc.2012.12.058 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23743123 }} </ref>
*[[Antiphospholipid syndrome]]<ref name="pmid23743123">{{cite journal| author=Scantlebury DC, Nkomo VT, Enriquez-Sarano M| title=Antiphospholipid syndrome and recurrent thrombotic valve disease. | journal=J Am Coll Cardiol | year= 2013 | volume= 61 | issue= 23 | pages= e177 | pmid=23743123 | doi=10.1016/j.jacc.2012.12.058 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23743123 }} </ref>
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*[[dilated cardiomyopathy|X-linked dilated cardiomyopathy]]
*[[dilated cardiomyopathy|X-linked dilated cardiomyopathy]]
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==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Crowdiagnosis]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]
[[Category:Valvular heart disease]]
[[Category:Valvular heart disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]

Latest revision as of 15:56, 18 December 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed A. Sbeih, M.D. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.; Mugilan Poongkunran M.B.B.S [4]

Overview

The causes of mitral regurgitation (MR) depend on the acuity of the valvular abnormality and the underlying pathological mechanism. Acute MR occurs when there is sudden disruption of one or more of the components of the mitral valve, such as leaflet perforation, rupture of a chordae tendineae, or rupture of the papillary muscle. The sudden disruption of the mitral valve can be caused by infective endocarditis, degenerative mitral valve disease, or acute ST elevation myocardial infarction.[1] Chronic primary MR is most commonly caused by mitral valve prolapse; other causes include rheumatic fever and Marfan's syndrome. Chronic secondary MR results from the dysfunction and dilatation of the left ventricle rather than an intrinsic abnormality in one of the components of the mitral valve and it can be caused by coronary artery disease (ischemic) or any disease causing left ventricular dysfunction and dilatation (functional).[2]

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.[3][4]

Common Causes

Acute Mitral Regurgitation

Chronic Mitral Regurgitation

Primary Mitral Regurgitation
Secondary Mitral Regurgitation

Causes by Organ System

Cardiovascular Acute coronary syndrome, aortic insufficiency, atrial septal defect (ostium primum), carcinoid syndrome, cardiac myxoma, cardiac tumors, congenital heart disease, congestive heart failure, coronary artery disease, dilated cardiomyopathy, endocardial cushion defect, endocarditis, endomyocardial fibrosis, hypertrophic cardiomyopathy, hypertensive heart disease, infective endocarditis, ischemic heart disease, Kawasaki disease, left ventricle dialation, mitral annular calcification, mitral valve prolapse, myocardial rupture, myocarditis, NSTEMI, papillary muscle rupture, rheumatic heart disease, STEMI, Takotsubo cardiomyopathy
Chemical / poisoning No underlying causes.
Dermatologic Psoriatic arthropathy
Drug Side Effect 3,4-Methylenedioxymethamphetamine, cabergoline, dexfenfluramine, ergotamine, fenfluramine, fluoxetine, methysergide, paroxetine, pergolide, phentermine, sertraline
Ear Nose Throat No underlying causes.
Endocrine No underlying causes.
Environmental No underlying causes.
Gastroenterologic No underlying causes.
Genetic Barth syndrome, Becker muscular dystrophy, Cohen syndrome, Duchenne muscular dystrophy, Emery-Dreifuss muscular dystrophy, Fabry disease, familial hypertrophic cardiomyopathy, Friedreich ataxia, Marfan's syndrome, myotonic dystrophy, osteogenesis imperfecta, polycystic kidney disease, Pompe's disease, pseudoxanthoma elasticum, Turner syndrome, X-linked dilated cardiomyopathy
Hematologic Antiphospholipid syndrome
Iatrogenic Balloon valvuloplasty of the mitral valve, cardiac catheterization, cardiopulmonary resuscitation, cathether ablation for arrhythmias, heart surgery, pacemaker syndrome, percutaneous coronary intervention, postpericardiotomy syndrome, prosthetic valve dysfunction
Infectious Disease Chagas disease, cytomegalovirus, diphtheria, ECHO virus, infective endocarditis, Lyme disease, myocarditis, pneumococcus, rheumatic fever,coxsackie B virus, rickettsial disease, staphylococcus, streptococcus
Musculoskeletal / Ortho Ankylosing spondylitis, Becker muscular dystrophy, Duchenne muscular dystrophy, Ehlers-Danlos syndrome, Emery-Dreifuss muscular dystrophy, Marfan's syndrome, osteogenesis imperfecta, psoriatic arthropathy, rheumatoid arthritis
Neurologic Friedreich ataxia
Nutritional / Metabolic Barth syndrome, Fabry disease, Pompe's disease
Obstetric/Gynecologic Peripartum cardiomyopathy
Oncologic Carcinoid syndrome, cardiac myxoma, cardiac tumors
Opthalmologic No underlying causes.
Overdose / Toxicity No underlying causes.
Psychiatric Takotsubo cardiomyopathy
Pulmonary No underlying causes.
Renal / Electrolyte End stage renal disease, polycystic kidney disease
Rheum / Immune / Allergy Ankylosing spondylitis, Behçet's disease, Ehlers-Danlos syndrome, Marfan's syndrome, osteogenesis imperfecta, polychondritis, rheumatic heart disease, rheumatoid arthritis, Sjögren's syndrome, systemic lupus erythematosus, temporal arteritis
Sexual No underlying causes.
Trauma Blunt or penetrating chest trauma
Urologic No underlying causes.
Miscellaneous Alcoholism, athletes, functional mitral regurgitation

Causes in Alphabetical Order

References

  1. ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 63 (22): 2438–88. doi:10.1016/j.jacc.2014.02.537. PMID 24603192.
  2. ↑ Ciarka A, Van de Veire N (2011). "Secondary mitral regurgitation: pathophysiology, diagnosis, and treatment". Heart. 97 (12): 1012–23. doi:10.1136/hrt.2010.219170. PMID 21586426.
  3. ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 63 (22): 2438–88. doi:10.1016/j.jacc.2014.02.537. PMID 24603192.
  4. ↑ Ciarka A, Van de Veire N (2011). "Secondary mitral regurgitation: pathophysiology, diagnosis, and treatment". Heart. 97 (12): 1012–23. doi:10.1136/hrt.2010.219170. PMID 21586426.
  5. ↑ Koide T, Kato A, Takabatake Y, Iizuka M, Uchida Y, Ozeki K; et al. (1980). "Variable prognosis in congestive cardiomyopathy. Role of left ventricular function, alcoholism, and pulmonary thrombosis". Jpn Heart J. 21 (4): 451–63. PMID 7420729.
  6. ↑ Scantlebury DC, Nkomo VT, Enriquez-Sarano M (2013). "Antiphospholipid syndrome and recurrent thrombotic valve disease". J Am Coll Cardiol. 61 (23): e177. doi:10.1016/j.jacc.2012.12.058. PMID 23743123.
  7. ↑ Bhattacharyya S, Schapira AH, Mikhailidis DP, Davar J (2009). "Drug-induced fibrotic valvular heart disease". Lancet. 374 (9689): 577–85. doi:10.1016/S0140-6736(09)60252-X. PMID 19683643.
  8. ↑ Penaranda Canal JG, Enriquez-Sarano M, Asirvatham SJ, Munger TM, Friedman PA, Suri RM (2013). "Mitral valve injury after radiofrequency ablation for Wolff-Parkinson-White syndrome". Circulation. 127 (25): 2551–2. doi:10.1161/CIRCULATIONAHA.113.002711. PMID 23797742.
  9. ↑ 9.0 9.1 9.2 9.3 Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7153-6. Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease
  10. ↑ Hendrikx M, Van Dorpe J, Flameng W, Daenen W (1996). "Aortic and mitral valve disease induced by ergotamine therapy for migraine: a case report and review of the literature". J Heart Valve Dis. 5 (2): 235–7. PMID 8665020.
  11. ↑ Wilke A, Hesse H, Hufnagel G, Maisch B (1997). "Mitral, aortic and tricuspid valvular heart disease associated with ergotamine therapy for migraine". Eur Heart J. 18 (4): 701. PMID 9129909.
  12. ↑ Functional mitral regurgitation By William H Gaasch, MD. Retrieved on Jul 8, 2010
  13. ↑ Bana DS, MacNeal PS, LeCompte PM, Shah Y, Graham JR (1974). "Cardiac murmurs and endocardial fibrosis associated with methysergide therapy". Am Heart J. 88 (5): 640–55. PMID 4420941.
  14. ↑ Barold SS, Ovsyshcher IE (2005). "Pacemaker-induced mitral regurgitation". Pacing Clin Electrophysiol. 28 (5): 357–60. doi:10.1111/j.1540-8159.2005.09486.x. PMID 15869664.
  15. ↑ Pritchett AM, Morrison JF, Edwards WD, Schaff HV, Connolly HM, Espinosa RE (2002). "Valvular heart disease in patients taking pergolide". Mayo Clin Proc. 77 (12): 1280–6. doi:10.4065/77.12.1280. PMID 12479512.
  16. ↑ Haghi D, Röhm S, Suselbeck T, Borggrefe M, Papavassiliu T (2010). "Incidence and clinical significance of mitral regurgitation in Takotsubo cardiomyopathy". Clinical Research in Cardiology : Official Journal of the German Cardiac Society. 99 (2): 93–8. doi:10.1007/s00392-009-0078-1. PMID 19774331. Retrieved 2011-04-16. Unknown parameter |month= ignored (help)
  17. ↑ Brunetti ND, Ieva R, Rossi G, Barone N, De Gennaro L, Pellegrino PL, Mavilio G, Cuculo A, Di Biase M (2008). "Ventricular outflow tract obstruction, systolic anterior motion and acute mitral regurgitation in Tako-Tsubo syndrome". International Journal of Cardiology. 127 (3): e152–7. doi:10.1016/j.ijcard.2007.04.149. PMID 17692942. Retrieved 2011-04-16. Unknown parameter |month= ignored (help)

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