Mitral regurgitation
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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
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Synonyms and Keywords: Mitral insufficiency, mitral regurge, MR.
Mitral regurgitation (MR), mitral insufficiency or mitral incompetence is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle, through the mitral valve, and into the left atrium, when the left ventricle contracts, i.e. there is regurgitation of blood back into the left atrium.[1] MR is the most common form of valvular heart disease.[2]
Pathophysiology
Epidemiology
Natural History
Diagnosis
Differential Diagnosis
Common causes of Mitral Regurgitation: Mitral valve prolapse | Rheumatic heart disease | Ischemic mitral regurgitation | Papillary muscle rupture | Endocarditis
Symptoms
Physical Examination
Chest x-ray
Ventriculogram
Echocardiography
Treatment
- In patients with mitral regurgitation (acute or chronic) with hemodynamic instability, electrocardiogram should be done to assess for Myocardial Infarction. In its absence, workup of infective endocarditis should be done with blood cultures.
- Diuretics are administered in patients with pulmonary congestion.
- After load should be reduced with vasodilators and diuretics.
- In presence of atrial fibrillation, beta blocker, calcium channel blocker or digoxin can be considered.
- Anti-coagulation therapy is considered in patients with atrial fibrillation and mitral valve replacement surgery.
- Prophylactic antibiotics prior periodontal procedure which involves manipulation of gingival tissue, the periapical region of a tooth, or perforation of oral mucosa is recommended in patients with previous infective endocarditis, prosthetic mitral valve and congentital heart disease.[3]
Acute Mitral Regurgitation | Chronic Mitral Regurgitation
Complications and Prognosis
References
- ↑ Mitral valve regurgitation at Mount Sinai Hospital
- ↑ Weinrauch, LA (2008-05-12). "Mitral regurgitation - chronic". Medline Plus Encyclopedia. U.S. National Library of Medicine and National Institutes of Health. Retrieved 2009-12-04.
- ↑ Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bolger A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT (2007). "Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group". Circulation. 116 (15): 1736–54. doi:10.1161/CIRCULATIONAHA.106.183095. PMID 17446442. Retrieved 2011-03-16. Unknown parameter
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See also
External Links
- Echo in context: Video lessons and slides of mitral regurgitation
- Yale atlas of echocardiography: Mitral regurgitation
- Mitral Regurgitation information from Seattle Children's Hospital Heart Center
- Mitral Valve Repair at The Mount Sinai Hospital
- NEW Investigational Treatment in the EVEREST II Clinical Research Study - Percutaneous Mitral Repair
Acknowledgements
The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.
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