Ischemic mitral regurgitation

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Ischemic mitral regurgitation can occur as one of the complications in both patients with Myocardial Infarction (MI) and Acute Ischemia.

Mitral Regurgitation is permanent in case of MI while in Acute Ischemia, it resolves with resolution of ischemia.

Ischemic Mitral Regurgitation can be due to :

• Papillary muscle rupture secondary to Acute MI.
• Majority of Ischemic Mitral Regurgitation are “Functional” due to “papillary muscle displacement” involving Left Ventricular-wall motion abnormality & alteration in the ventricular geometry.

Diagnosis

Symptoms

The clinical presentation of Ischemic mitral regurgitation reflects the state of Left ventricular-dysfunction more than the state of mitral valve.

• Asymptomatic detected by Echocardiography or Angiography
• Weakness , Fatigue
• Exercise Intolerance

Signs

• About one half have Holosystolic murmur
• Decreased cardiac output
• Exercise produces severe regurgitation in patients with mild Ischemic mitral regurgitation.
• Severe cases present with pulmonary edema.

Treatment

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