Ischemic mitral regurgitation: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
Independent of left ventricular function, MR is associated with higher mortality <ref name="pmid11282907">{{cite journal |author=Grigioni F, Enriquez-Sarano M, Zehr KJ, Bailey KR, Tajik AJ |title=Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment |journal=[[Circulation]] |volume=103 |issue=13 |pages=1759–64 |year=2001 |month=April |pmid=11282907 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=11282907 |issn= |accessdate=2011-02-20}}</ref>. | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
Revision as of 15:41, 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.
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Treatment
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Prognosis
Independent of left ventricular function, MR is associated with higher mortality [1].
References
- ↑ Grigioni F, Enriquez-Sarano M, Zehr KJ, Bailey KR, Tajik AJ (2001). "Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment". Circulation. 103 (13): 1759–64. PMID 11282907. Retrieved 2011-02-20. Unknown parameter
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