Ischemic mitral regurgitation: Difference between revisions
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'''Associate Editors-In-Chief:''' Varun Kumar, M.B.B.S ; Lakshmi Gopalakrishnan, M.B.B.S | '''Associate Editors-In-Chief:''' [[Varun Kumar]], M.B.B.S ; [[Lakshmi Gopalakrishnan]], M.B.B.S | ||
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* Asymptomatic detected by Echocardiography or Angiography | * Asymptomatic detected by Echocardiography or Angiography | ||
* Weakness , | * [[Weakness]], [[fatigue]] | ||
* Exercise Intolerance | * Exercise Intolerance | ||
===Signs=== | ===Signs=== | ||
* | * Approximately one half have holosystolic [[murmur]] | ||
* Decreased cardiac output | * Decreased [[cardiac output]] | ||
* Exercise produces severe regurgitation in patients with mild | * Exercise produces severe regurgitation in patients with mild ischemic mitral regurgitation. | ||
* Severe cases present with pulmonary edema | * Severe cases present with [[pulmonary edema]] | ||
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* Exercise induced ERO ≥13 mm2 is an independent predictor of cardiac death. | * Exercise induced ERO ≥13 mm2 is an independent predictor of cardiac death. | ||
*<youtube v=ue2oCXo6Qik/> | |||
* <youtube v=ue2oCXo6Qik/> | |||
==Treatment== | ==Treatment== | ||
Revision as of 15:31, 20 February 2011
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editors-In-Chief: Varun Kumar, M.B.B.S ; Lakshmi Gopalakrishnan, M.B.B.S
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Overview
Ischemic mitral regurgitation can occur as a complication of either ST elevation myocardial infarction (MI) and acute myocardial ischemia. If mitral regurgitation occurs as a complication of MI it is permanent while if it occurs as a result of ischemia, it is transient and resolves with resolution of ischemia.
Pathophysiology
Ischemic Mitral Regurgitation can be due to :
- Papillary muscle rupture secondary to acute MI.
- Most often Ischemic Mitral Regurgitation is “functional” and due to “papillary muscle displacement” involving a left ventricular-wall motion abnormality as well as alteration in left ventricular geometry.
Epidemiology
Natural History
Diagnosis
Symptoms
The clinical presentation of Ischemic mitral regurgitation reflects the state of Left ventricular-dysfunction more than the state of mitral valve.
Signs
- Approximately 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
Exercise Echocardiography
- Effective regurgitant orifice (ERO) area increase with exercise is associated with increased risk for acute pulmonary edema
- Exercise induced ERO ≥13 mm2 is an independent predictor of cardiac death.
- <youtube v=ue2oCXo6Qik/>
Treatment
<youtube v=vWUos-0WM5w/>