Mitral regurgitation causes: Difference between revisions

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==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.  There are several phases of mitral regurgitation (acute, chronic compensated, and chronic decompensated).
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.


==Mechanical Basis of Mitral Regurgitation==
==Causes==
In broad terms, mitral regurgitation (MR) can be caused either by intrinsic defects in the mitral valve (e.g. degeneration of the valvle due to [[chordal rupture]] as would be seen with [[infective endocarditis]] or [[mitral valve prolapse]] or by defects in the left ventricle ventricle causing "functional" mitral regurgitation (e.g. [[dilated cardiomyopathy]], [[ischemic heart disease]]).
===Life Threatening Causes===
 
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Specific mechanical defects underlying mitral regurgitation include the following:
*[[Acute coronary syndrome]]
 
*[[chest trauma|Blunt or penetrating chest trauma]]
*Anterior mitral leaflet prolapse
*[[Infective endocarditis]]
*Posterior mitral leaflet prolapse
*[[Myocardial rupture]]
*Bileaflet prolapse
*[[NSTEMI]]
*Restricted mitral leaflets
*Apical tethering
*[[Papillary muscle rupture]]
*[[Papillary muscle rupture]]
*Ischemic papillary muscle rupture
*[[STEMI]]
*Mitral leaflet perforation
*[[Temporal arteritis]]
*Rupture or tear of the chordae tendineae
*Dilation of the mitral annulus
*"Functional MR" due to dilation of the heart itself
 
==Causes==


===Common Causes===
===Common Causes===
====Acute Mitral Regurgitation====
====Acute Mitral Regurgitation====
* [[Heart attack]] or [[acute MI]]: Dysfunction or injury to the mitral valve following a heart attack. [[Papillary muscle rupture]] or dysfunction that is associated with [[ST elevation myocardial infarction]].
* [[Acute coronary syndrome]]
* [[Endocarditis]]: The infaction may cause perforation of the leaflet, erosion of the surrounding structures, or a vagetation may not permit the leaflets to coapt.
* [[Papillary muscle rupture]]
* Chordal rupture
* [[Infective endocarditis]]
* [[Trauma]]
* [[chest trauma|Blunt or penetrating chest trauma]]


====Chronic Mitral Regurgitation====
====Chronic Mitral Regurgitation====
* [[Mitral valve prolapse]]:  This disorder now accounts for 45% of cases of mitral regurgitation in the Western world.
*[[Congestive heart disease]]
* [[Ischemic heart disease]] / [[Coronary artery disease]]:  This can be due to either papillary muscle dysfunction or left ventricular dilation and functional mitral regurgitation.  Ischemia is responsible for 3% to 25% of MR cases.
*[[Ischemic heart disease]]
* [[Rheumatic heart disease]]:  In the past, this was the most common cause of MR in the Western world. In developing countries, [[rheumatic heart disease]] remains the most common cause.
*[[Mitral valve prolapse]]
*[[Rheumatic heart disease]]


==Causes by Organ System==
===Causes by Organ System===


{|style="width:70%; height:100px" border="1"
{|style="width:70%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | Atrial septal defect (ostium primum), balloon valvuloplasty of the mitral valve, dilatation of the [[left ventricle]], causing stretching of the [[mitral valve]] annulus and displacement of the [[papillary muscles]] <ref>[http://www.uptodate.com/patients/content/topic.do?topicKey=~Ux3kbGWsXmiaqiH Functional mitral regurgitation] By William H Gaasch, MD. Retrieved on Jul 8, 2010</ref>(causes include [[aortic insufficiency]],[[dilated cardiomyopathy]] and [[Takotsubo cardiomyopathy]] <ref name="pmid19774331">{{cite journal |author=Haghi D, Röhm S, Suselbeck T, Borggrefe M, Papavassiliu T |title=Incidence and clinical significance of mitral regurgitation in Takotsubo cardiomyopathy |journal=[[Clinical Research in Cardiology : Official Journal of the German Cardiac Society]] |volume=99 |issue=2 |pages=93–8 |year=2010 |month=February |pmid=19774331 |doi=10.1007/s00392-009-0078-1|url=http://dx.doi.org/10.1007/s00392-009-0078-1 |accessdate=2011-04-16}}</ref><ref name="pmid17692942">{{cite journal |author=Brunetti ND, Ieva R, Rossi G, Barone N, De Gennaro L, Pellegrino PL, Mavilio G, Cuculo A, Di Biase M |title=Ventricular outflow tract obstruction, systolic anterior motion and acute mitral regurgitation in Tako-Tsubo syndrome |journal=[[International Journal of Cardiology]] |volume=127 |issue=3 |pages=e152–7 |year=2008 |month=July |pmid=17692942|doi=10.1016/j.ijcard.2007.04.149 |url=http://linkinghub.elsevier.com/retrieve/pii/S0167-5273(07)01161-8 |accessdate=2011-04-16}}</ref>), dysfunction or injury to the mitral valve following a heart attack,
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Acute coronary syndrome]], [[aortic insufficiency]], [[Atrial septal defect|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]], [[cardiomegaly|left ventricle dialation]], [[mitral annular calcification]], [[mitral valve prolapse]], [[myocardial rupture]], [[myocarditis]], [[NSTEMI]], [[papillary muscle rupture]], [[rheumatic heart disease]], [[STEMI]], [[Takotsubo cardiomyopathy]]
endomyocardial fibrosis, endocardial cushion defect, familial hypertrophic cardiomyopathy, heart tumors, high blood pressure, infection of the heart valve (infective endocarditis) <ref name=agabegi2nd-ch1>{{cite book|author=Elizabeth D Agabegi; Agabegi, Steven S. |title=Step-Up to Medicine (Step-Up Series) |publisher=Lippincott Williams & Wilkins|location=Hagerstwon, MD |year=2008 |pages=|isbn=0-7817-7153-6 |oclc= |doi= |accessdate=}}  Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease</ref>, [[ischemic heart disease]] ([[coronary artery disease]]), [[mitral annular]] calcification, [[mitral valve prolapse]] (accounts for 45% of cases in the western world <ref name='MedicineNetMVP-Kulick'>{{cite web|url=http://www.medicinenet.com/mitral_valve_prolapse/article.htm|title=Mitral Valve Prolapse (MVP) |accessdate=2010-01-18 |last=Kulick |first=Daniel|work=MedicineNet.com |publisher=MedicineNet, Inc }}</ref>, 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), myxomatous degeneration.
 
[[Papillary muscle rupture]] or dysfunction that is associated with [[ST elevation myocardial infarction]] <ref name=agabegi2nd-ch1/>, [[prosthetic valve]] dysfunction, [[rheumatic heart disease]] (this was the most common cause of MR in the western world) and swelling of the left lower heart chamber.
 
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes.
|bgcolor="Beige"| [[Psoriatic arthropathy]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| Certain forms of medication can cause mitral regurgitation such as [[cabergoline]], [[fenfluramine]], [[methysergide]] and [[pergolide]].
|bgcolor="Beige"| [[Cabergoline]], [[dexfenfluramine]], [[ergotamine]], [[fenfluramine]], [[fluoxetine]], [[3,4-methylenedioxymethamphetamine]], [[methysergide]], [[paroxetine]], [[pergolide]], [[phentermine]], [[sertraline]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| Chromosomal abnormalities such as [[turner syndrome]], mendelian inherited conditions: [[Autosomal dominant]] conditions such as contractural arachnodactyly, familial hypertrophic cardiomyopathy, [[osteogenesis imperfecta]] and [[polycystic kidney disease]]-adult, [[autosomal recessive]] conditions such as cohen syndrome and pseudoxanthoma elasticum, [[X-linked]] inherited conditions such as [[fabry disease]].
|bgcolor="Beige"| [[Barth syndrome]], [[Becker muscular dystrophy]], [[Cohen syndrome]], [[Duchenne muscular dystrophy]], [[Emery-Dreifuss muscular dystrophy]], [[Fabry disease]], [[hypertrophic cardiomyopathy|familial hypertrophic cardiomyopathy]], [[Friedreich ataxia]], [[Marfan's syndrome]], [[myotonic dystrophy]], [[osteogenesis imperfecta]], [[polycystic kidney disease]], [[Pompe's disease]], [[pseudoxanthoma elasticum]], [[Turner syndrome]], [[dilated cardiomyopathy|X-linked dilated cardiomyopathy]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes.
|bgcolor="Beige"| [[Antiphospholipid syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes.
|bgcolor="Beige"| [[balloon valvuloplasty|Balloon valvuloplasty of the mitral valve]], [[cardiac catheterization]], [[cardiopulmonary resuscitation]], [[catheter ablation|cathether ablation for arrhythmias]], [[heart surgery]], [[pacemaker syndrome]], [[percutaneous coronary intervention]], [[postpericardiotomy syndrome]], [[prosthetic valve|prosthetic valve dysfunction]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Infective endocarditis]] (the predominant organism is ''[[Staphylococcus aureus|S. aureus]]'' <ref name=agabegi2nd-ch1>{{cite book|author=Elizabeth D Agabegi; Agabegi, Steven S. |title=Step-Up to Medicine (Step-Up Series) |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |pages=|isbn=0-7817-7153-6 |oclc= |doi= |accessdate=}}  Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease</ref>, but varies depending upon the patient) and untreated [[syphilis]] (rare).
|bgcolor="Beige"| [[Chagas disease]], [[cytomegalovirus]], [[diphtheria]], [[ECHO virus]], [[infective endocarditis]], [[Lyme disease]], [[myocarditis]], [[pneumococcus]], [[rheumatic fever]],[[coxsackie B virus]], [[rickettsial disease]], [[staphylococcus]], [[streptococcus]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| Contractural arachnodactyly.
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Becker muscular dystrophy]], [[Duchenne muscular dystrophy]], [[Ehlers-Danlos syndrome]], [[Emery-Dreifuss muscular dystrophy]], [[Marfan's syndrome]], [[osteogenesis imperfecta]], [[psoriatic arthropathy]], [[rheumatoid arthritis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes.
|bgcolor="Beige"| [[Friedreich ataxia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes.
|bgcolor="Beige"| [[Barth syndrome]], [[Fabry disease]], [[Pompe's disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes.
|bgcolor="Beige"| [[Peripartum cardiomyopathy]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| Heart tumors.
|bgcolor="Beige"| [[Carcinoid syndrome]], [[cardiac myxoma]], [[cardiac tumors]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes.
|bgcolor="Beige"| [[Takotsubo cardiomyopathy]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Polycystic kidney disease]]-adult (autosomal dominant type).
|bgcolor="Beige"| [[End stage renal disease]], [[polycystic kidney disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[collagen vascular disease]]s such as [[marfan's syndrome]], [[ehlers-danlos syndrome]] and [[osteogenesis imperfecta]], rheumatic Heart Disease, [[rheumatoid arthritis]], systemic lupus erythematosus ([[Systemic Lupus Erythematosus|SLE]]) <ref name=agabegi2nd-ch1/>, polychondritis.
|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="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| Trauma to the heart (stab wound).
|bgcolor="Beige"| [[chest trauma|Blunt or penetrating chest trauma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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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 ([[atrial septal defect]] (ostium primum).
|bgcolor="Beige"| [[Alcoholism]], [[athletes]], [[functional mitral regurgitation]]
|-
|-
|}
|}


==Causes of Acute Mitral regurgitation in Alphabetical Order==
===Causes in Alphabetical Order===
 
{{col-begin|width=80%}}
*Balloon valvuloplasty of the [[mitral valve]]
{{col-break|width=33%}}
*[[Infective endocarditis]] <ref name=agabegi2nd-ch1>{{cite book|author=Elizabeth D Agabegi; Agabegi, Steven S. |title=Step-Up to Medicine (Step-Up Series) |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |pages=|isbn=0-7817-7153-6 |oclc= |doi= |accessdate=}} Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease</ref>
*[[3,4-methylenedioxymethamphetamine]]
*[[Papillary muscle rupture]] <ref name=agabegi2nd-ch1/>
*[[Acute coronary syndrome]]
*[[ST elevation myocardial infarction]]
*[[Alcoholism]]
*Trauma with disruption of the [[chordae tendineae]]
 
==Causes of Chronic Mitral regurgitation in Alphabetical Order==
 
*Atrial septal defect (Ostium primum)
*[[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>
*[[Aortic insufficiency]]
*[[Aortic insufficiency]]
*[[Autosomal recessive]] conditions
*[[Athletes]]
*[[Cabergoline]]
*[[Atrial septal defect|Atrial septal defect (Ostium primum)]]
*[[Collagen vascular disease]]s
*[[balloon valvuloplasty|Balloon valvuloplasty of the mitral valve]]
*Contractural [[arachnodactyly]]
*[[Barth syndrome]]
*Dilatation of the [[left ventricle]]
*[[Becker muscular dystrophy]]
*[[Behçet's disease]]
*[[chest trauma|Blunt or penetrating chest trauma]]
*[[Cabergoline]]<ref name="pmid19683643">{{cite journal| author=Bhattacharyya S, Schapira AH, Mikhailidis DP, Davar J| title=Drug-induced fibrotic valvular heart disease. | journal=Lancet | year= 2009 | volume= 374 | issue= 9689 | pages= 577-85 | pmid=19683643 | doi=10.1016/S0140-6736(09)60252-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19683643 }} </ref>
*[[Carcinoid syndrome]]
*[[Cardiac catheterization]]
*[[Cardiac myxoma]]
*[[Cardiac tumor]]
*[[Cardiopulmonary resuscitation]]
*[[catheter ablation|Cathether ablation for arrhythmias]]<ref name="pmid23797742">{{cite journal| author=Penaranda Canal JG, Enriquez-Sarano M, Asirvatham SJ, Munger TM, Friedman PA, Suri RM| title=Mitral valve injury after radiofrequency ablation for Wolff-Parkinson-White syndrome. | journal=Circulation | year= 2013 | volume= 127 | issue= 25 | pages= 2551-2 | pmid=23797742 | doi=10.1161/CIRCULATIONAHA.113.002711 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23797742 }} </ref>
*[[Chagas disease]]
*[[Cohen syndrome]]
*[[Congenital heart disease]]
*[[Congestive heart disease]]
*[[Coxsackie B virus]]
*[[Cytomegalovirus]]
*[[Dexfenfluramine]]
*[[Dilated cardiomyopathy]]
*[[Dilated cardiomyopathy]]
*[[Ehlers-danlos syndrome]]
*[[Diphtheria]]
*[[Endocarditis]] <ref name=agabegi2nd-ch1>{{cite book|author=Elizabeth D Agabegi; Agabegi, Steven S. |title=Step-Up to Medicine (Step-Up Series) |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |pages=|isbn=0-7817-7153-6 |oclc= |doi= |accessdate=}}  Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease</ref>
*[[Duchenne muscular dystrophy]]
{{col-break|width=33%}}
*[[ECHO virus]]
*[[Ehlers-Danlos syndrome]]
*[[Emery-Dreifuss muscular dystrophy]]
*[[Endocardial cushion defect]]
*[[Endocardial cushion defect]]
*[[Endocarditis]] <ref name=agabegi2nd-ch1>{{cite book|author=Elizabeth D Agabegi; Agabegi, Steven S. |title=Step-Up to Medicine (Step-Up Series) |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2008 |pages=|isbn=0-7817-7153-6 |oclc= |doi= |accessdate=}} Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease</ref>
*[[Endomyocardial fibrosis]]
*[[Endomyocardial fibrosis]]
*[[Ergotamine]]<ref name="pmid8665020">{{cite journal| author=Hendrikx M, Van Dorpe J, Flameng W, Daenen W| title=Aortic and mitral valve disease induced by ergotamine therapy for migraine: a case report and review of the literature. | journal=J Heart Valve Dis | year= 1996 | volume= 5 | issue= 2 | pages= 235-7 | pmid=8665020 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8665020 }} </ref><ref name="pmid9129909">{{cite journal| author=Wilke A, Hesse H, Hufnagel G, Maisch B| title=Mitral, aortic and tricuspid valvular heart disease associated with ergotamine therapy for migraine. | journal=Eur Heart J | year= 1997 | volume= 18 | issue= 4 | pages= 701 | pmid=9129909 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9129909 }} </ref>
*[[Fabry disease]]
*[[Fabry disease]]
*[[hypertrophic cardiomyopathy|Familial hypertrophic cardiomyopathy]]
*[[Fenfluramine]]
*[[Fenfluramine]]
*[[Functional mitral regurgitation]] due to left ventricular dilation
*[[Fluoxetine]]
*[[Friedreich ataxia]]
*[[Functional mitral regurgitation]]
*[[Heart surgery]]
*[[Heart tumors]]
*[[Heart tumors]]
*[[Hypertension]]
*[[Hypertensive heart disease]]
*[[Hypertrophic obstructive cardiomyopathy]] ([[HOCM]])
*[[Hypertrophic cardiomyopathy]]
*[[Ischemic heart disease]] ([[Coronary artery disease]])
*[[Infective endocarditis]]<ref name=agabegi2nd-ch1>{{cite book|author=Elizabeth D Agabegi; Agabegi, Steven S. |title=Step-Up to Medicine (Step-Up Series) |publisher=Lippincott Williams & Wilkins|location=Hagerstwon, MD |year=2008 |pages=|isbn=0-7817-7153-6 |oclc= |doi= |accessdate=}} Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease</ref>
*[[Marfan's syndrome]]  
*[[Ischemic heart disease]]
*[[Methysergide]]
*[[Kawasaki disease]]
*[[cardiomegaly|Left ventricle dialation]]<ref>[http://www.uptodate.com/patients/content/topic.do?topicKey=~Ux3kbGWsXmiaqiH Functional mitral regurgitation] By William H Gaasch, MD. Retrieved on Jul 8, 2010</ref>
*[[Marfan's syndrome]]
*[[Methysergide]]<ref name="pmid4420941">{{cite journal| author=Bana DS, MacNeal PS, LeCompte PM, Shah Y, Graham JR| title=Cardiac murmurs and endocardial fibrosis associated with methysergide therapy. | journal=Am Heart J | year= 1974 | volume= 88 | issue= 5 | pages= 640-55 | pmid=4420941 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4420941 }} </ref>
*[[Mitral valve prolapse]]
*[[Mitral valve prolapse]]
*[[Myocardial rupture]]
*[[Myocarditis]]
*[[Myotonic dystrophy]]
*[[NSTEMI]]
*[[Lyme disease]]
*[[Osteogenesis imperfecta]]
*[[Osteogenesis imperfecta]]
*[[Pergolide]]
{{col-break|width=33%}}
*[[Pacemaker syndrome]]<ref name="pmid15869664">{{cite journal| author=Barold SS, Ovsyshcher IE| title=Pacemaker-induced mitral regurgitation. | journal=Pacing Clin Electrophysiol | year= 2005 | volume= 28 | issue= 5 | pages= 357-60 | pmid=15869664 | doi=10.1111/j.1540-8159.2005.09486.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15869664 }} </ref>
*[[Papillary muscle rupture]]
*[[Paroxetine]]
*[[Percutaneous coronary intervention]]
*[[Pergolide]]<ref name="pmid12479512">{{cite journal| author=Pritchett AM, Morrison JF, Edwards WD, Schaff HV, Connolly HM, Espinosa RE| title=Valvular heart disease in patients taking pergolide. | journal=Mayo Clin Proc | year= 2002 | volume= 77 | issue= 12 | pages= 1280-6 | pmid=12479512 | doi=10.4065/77.12.1280 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12479512 }} </ref>
*[[Peripartum cardiomyopathy]]
*[[Phentermine]]
*[[Pneumococcus]]
*[[Polychondritis]]
*[[Polychondritis]]
*[[Polycystic kidney disease]]-adult (autosomal dominant type)
*[[Polycystic kidney disease]]
*[[Pompe's disease]]
*[[Postpericardiotomy syndrome]]
*[[prosthetic valve|Prosthetic valve dysfunction]]
*[[Pseudoxanthoma elasticum]]
*[[Pseudoxanthoma elasticum]]
*[[Psoriatic arthropathy]]
*[[Rheumatic heart disease]]
*[[Rheumatic heart disease]]
*[[Rheumatoid disease]]
*[[Rheumatoid arthritis]]
*[[Systemic lupus erythematosus]] ([[SLE]])
*[[Rickettsial disease]]
*[[Sertraline]]
*[[Sjögren's syndrome]]
*[[Staphylococcus]]
*[[STEMI]]<ref name=agabegi2nd-ch1/>
*[[Streptococcus]]
*[[Syphilis]]
*[[Syphilis]]
*[[Takotsubo cardiomyopathy]]
*[[Systemic lupus erythematosus]] ([[SLE]])<ref name=agabegi2nd-ch1/>
*[[Takotsubo cardiomyopathy]]<ref name="pmid19774331">{{cite journal |author=Haghi D, Röhm S, Suselbeck T, Borggrefe M, Papavassiliu T |title=Incidence and clinical significance of mitral regurgitation in Takotsubo cardiomyopathy |journal=[[Clinical Research in Cardiology : Official Journal of the German Cardiac Society]] |volume=99 |issue=2 |pages=93–8 |year=2010 |month=February |pmid=19774331 |doi=10.1007/s00392-009-0078-1|url=http://dx.doi.org/10.1007/s00392-009-0078-1 |accessdate=2011-04-16}}</ref><ref name="pmid17692942">{{cite journal |author=Brunetti ND, Ieva R, Rossi G, Barone N, De Gennaro L, Pellegrino PL, Mavilio G, Cuculo A, Di Biase M |title=Ventricular outflow tract obstruction, systolic anterior motion and acute mitral regurgitation in Tako-Tsubo syndrome |journal=[[International Journal of Cardiology]] |volume=127 |issue=3 |pages=e152–7 |year=2008 |month=July |pmid=17692942|doi=10.1016/j.ijcard.2007.04.149 |url=http://linkinghub.elsevier.com/retrieve/pii/S0167-5273(07)01161-8 |accessdate=2011-04-16}}</ref>
*[[Temporal arteritis]]
*[[Turner syndrome]]
*[[Turner syndrome]]
*[[X-linked]] inherited conditions such as [[fabry disease]]
*[[dilated cardiomyopathy|X-linked dilated cardiomyopathy]]
{{col-end}}
<font color="white">{{Smallcaps|{{PAGENAME}} developed by WikiDoc.org}}</font>
 


==References==
==References==

Revision as of 18:27, 13 November 2013
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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.

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.

Causes

Life Threatening Causes

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

Common Causes

Acute Mitral Regurgitation

Chronic 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 Cabergoline, dexfenfluramine, ergotamine, fenfluramine, fluoxetine, 3,4-methylenedioxymethamphetamine, 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

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References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 4.0 4.1 4.2 4.3 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
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ Functional mitral regurgitation By William H Gaasch, MD. Retrieved on Jul 8, 2010
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ 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.
  11. ↑ 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)
  12. ↑ 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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