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Chromosomal abnormalities
 
Turner syndrome
Turner syndrome
Mendelian inherited conditions
Mendelian inherited conditions
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X-linked inherited conditions
X-linked inherited conditions
Fabry disease
Fabry disease
Atrial septal defect (ostium primum)
Atrial septal defect (ostium primum).




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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Collagen vascular disease]]s such as [[Marfan's syndrome]], [[rheumatoid]] disease and systemic lupus erythematosus ([[Systemic Lupus Erythematosus|SLE]]) <ref name=agabegi2nd-ch1/>, polychondritis,
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Collagen vascular disease]]s such as [[Marfan's syndrome]], [[rheumatoid]] disease and systemic lupus erythematosus ([[Systemic Lupus Erythematosus|SLE]]) <ref name=agabegi2nd-ch1/>, polychondritis.


|-
|-
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| Congenital (present from birth) mitral regurgitation is most often part of a more complex heart defect or syndrome.
|bgcolor="Beige"| Chromosomal abnormalities, Congenital (present from birth) mitral regurgitation is most often part of a more complex heart defect or syndrome (atrial septal defect (ostium primum).
|-
|-
|}
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In alphabetical order:
In alphabetical order:


*Atrial septal defect (ostium primum).
*[[Ankylosing spondylitis]].
*[[Aortic insufficiency]].
*[[Aortic insufficiency]].
*[[Cabergoline]] drug.
*[[Cabergoline]] drug.
*Chromosomal abnormalities.
*[[Collagen vascular disease]]s.
*[[Collagen vascular disease]]s.
*Dilatation of the [[left ventricle]].
*Dilatation of the [[left ventricle]].
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*[[Mitral valve prolapse]].
*[[Mitral valve prolapse]].
*[[Pergolide]] drug.
*[[Pergolide]] drug.
*Polychondritis.
*[[Rheumatic heart disease]].
*[[Rheumatic heart disease]].
*[[Rheumatoid]] disease.
*Swelling of the left lower heart chamber.
*Swelling of the left lower heart chamber.
*Systemic Lupus Erythematosus.
*Systemic Lupus Erythematosus.

Revision as of 17:36, 16 September 2011

Mitral Regurgitation Microchapters

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Overview

Classification

Pathophysiology

Causes

Differentiating Mitral Regurgitation from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

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Echocardiography

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Chronic Mitral Regurgitation Treatment

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.; Mohammed A. Sbeih, M.D. [3]

Overview

Regurgitation means leaking from a valve that doesn't close all the way. It is caused by diseases that weaken or damage the valve or its supporting structures. Mitral regurgitation becomes chronic when the condition persists rather than occurring for only a short time period. The causes of chronic mitral regurgitation should be distinguished from the acute mitral regurgitation causes.

Common Causes of Mitral Regurgitation

  • Acute Mitral Regurgitation.
  • Dysfunction or injury to the mitral valve following a heart attack. Papillary muscle rupture or dysfunction that is associated with ST elevation myocardial infarction.
  • Infection of the heart valve (infective endocarditis). These conditions may rupture the valve or surrounding structures, leaving an opening for blood to move backwards.
  • Trauma.
  • Chronic Mitral Regurgitation.


Turner syndrome Mendelian inherited conditions Ehlers-Danlos syndrome Autosomal dominant conditions Cardiomyopathy, familial hypertrophic Contractural arachnodactyly Osteogenesis imperfecta Polycystic kidney disease, adult (autosomal dominant) Autosomal recessive conditions Cohen syndrome Pseudoxanthoma elasticum X-linked inherited conditions Fabry disease Atrial septal defect (ostium primum).


Complete Differential Diagnosis of the Causes of Mitral Regurgitation

(By organ system)

Cardiovascular Balloon valvuloplasty of the mitral valve, dilatation of the left ventricle, causing stretching of the mitral valve annulus and displacement of the papillary muscles [1](causes include aortic insufficiency,dilated cardiomyopathy and Takotsubo cardiomyopathy [2][3]), dysfunction or injury to the mitral valve following a heart attack.

Endomyocardial fibrosis, endocardial cushion defect, heart tumors, high blood pressure, infection of the heart valve (infective endocarditis) [4], ischemic heart disease (coronary artery disease), mitral valve prolapse (accounts for 45% of cases in the western world [5], MVP is a common cause. However, most patients with MVP do not develop severe mitral regurgitation. Older age, male gender, and auscultatory evidence of severe MR are prognostic clues that identify patients with mitral valve prolapse who are at a relatively high risk of complications).

Papillary muscle rupture or dysfunction that is associated with ST elevation myocardial infarction [4], rheumatic heart disease (this was the most common cause of MR in the western world) and swelling of the left lower heart chamber.

Chemical / poisoning No underlying causes.
Dermatologic No underlying causes.
Drug Side Effect Certain forms of medication can cause mitral regurgitation such as cabergoline, fenfluramine, methysergide and pergolide.
Ear Nose Throat No underlying causes.
Endocrine No underlying causes.
Environmental No underlying causes.
Gastroenterologic No underlying causes.
Genetic No underlying causes.
Hematologic No underlying causes.
Iatrogenic No underlying causes.
Infectious Disease Infective endocarditis (the predominant organism is S. aureus [4], but varies depending upon the patient) and untreated syphilis (rare).
Musculoskeletal / Ortho No underlying causes.
Neurologic No underlying causes.
Nutritional / Metabolic No underlying causes.
Obstetric/Gynecologic No underlying causes.
Oncologic No underlying causes.
Opthalmologic No underlying causes.
Overdose / Toxicity No underlying causes.
Psychiatric No underlying causes.
Pulmonary No underlying causes.
Renal / Electrolyte No underlying causes.
Rheum / Immune / Allergy Ankylosing spondylitis, Collagen vascular diseases such as Marfan's syndrome, rheumatoid disease and systemic lupus erythematosus (SLE) [4], polychondritis.
Sexual No underlying causes.
Trauma Trauma to the heart (stab wound).
Urologic No underlying causes.
Miscellaneous Chromosomal abnormalities, Congenital (present from birth) mitral regurgitation is most often part of a more complex heart defect or syndrome (atrial septal defect (ostium primum).

Differential Diagnosis of the Causes of Acute Mitral Regurgitation

In alphabetical order:

Differential Diagnosis of the Causes of Chronic Mitral Regurgitation

In alphabetical order:

References

  1. ↑ Functional mitral regurgitation By William H Gaasch, MD. Retrieved on Jul 8, 2010
  2. ↑ 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)
  3. ↑ 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)
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 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
  5. ↑ Kulick, Daniel. "Mitral Valve Prolapse (MVP)". MedicineNet.com. MedicineNet, Inc. Retrieved 2010-01-18.


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