Degenerative Mitral Regurgitation: Assessment, Physical Examination, and Imaging

  • Nina C. WunderlichEmail author
  • Roy Beigel
  • Florian Rader
  • Jennifer Franke
  • Robert J. Siegel
Structural Heart Disease (RJ Siegel and NC Wunderlich, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Structural Heart Disease


Purpose of Review

In this review, we provide a comprehensive approach to assess degenerative mitral regurgitation.

Recent Findings

In the evaluation of MR, it is important to differentiate between primary (degenerative/organic) MR in which an intrinsic mitral valve lesion(s) is responsible for the occurrence of MR and secondary (functional) MR where the mitral valve is structurally normal, but alterations of the left ventricular geometry cause deterioration of the MV apparatus. Advanced imaging modalities, foremost two-dimensional and three-dimensional echocardiography, are essential for this determination.


In the evaluation of degenerative MR, the exact mechanism, the extent of the disease, associated valve lesions, the grade of mitral regurgitation severity, and hemodynamic consequences require careful assessment in order to provide patients with appropriate monitoring and treatment.


Mitral regurgitation Primary mitral regurgitation Degenerative mitral regurgitation Echocardiography Mitral valve prolapse Barlow’s disease Fibroelastic deficiency Papillary muscle rupture 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Nina C. Wunderlich
    • 1
    Email author
  • Roy Beigel
    • 2
  • Florian Rader
    • 3
  • Jennifer Franke
    • 4
  • Robert J. Siegel
    • 3
  1. 1.Cardiovascular Center DarmstadtDarmstadtGermany
  2. 2.The Heart Institute, Sheba Medical Center, and the Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Cedars-Sinai Medical CenterThe Heart InstituteLos AngelesUSA
  4. 4.Department of CardiologyUniversity of HeidelbergHeidelbergGermany

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