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Mitral Regurgitation

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Abstract

Mitral Valve Regurgitation (MR) is among the most common valvular diseases in the developed world, affecting 19 % of individuals in the United States. MR occurs when the mitral valve becomes incompetent as a result of a defect to any part of the mitral valve apparatus – the leaflets, chordae tendinae, papillary muscles, or mitral annulus. The location, time course, and extent of damage to the apparatus determine whether the pathology presents as Acute or Chronic MR. On physical exam, the classical holosystolic murmur of chronic MR is best heard over the apex, commencing immediately after S1 and continuing up to S2. It is most often “blowing,” high pitched in quality, and associated with a widening of S2. Acute MR is best heard along the left sternal border as an apical systolic murmur with early- and mid- systolic crescendo-decrescendo. Both Chronic and Acute MR may remain clinically asymptomatic or may lead to severely debilitating symptoms including dyspnea on exertion, orthopnea, and weakness. The presence of symptoms indicates progression to more severe disease and, therefore, is a poor prognostic indicator if not treated. While medical therapy may be an option in patients with milder disease, surgery is recommended in all patients with symptomatic severe MR or evidence of early systolic dysfunction.

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Author information

Authors and Affiliations

  1. Georgetown University School of Medicine, Georgetown University Hospital, Washington, DC, USA

    Bridget Kaufman BA, MD, Christopher Sonne BA, MD & Anly K. Tsang BA, MS, MD

Authors
  1. Bridget Kaufman BA, MD
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  2. Christopher Sonne BA, MD
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  3. Anly K. Tsang BA, MS, MD
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Corresponding author

Correspondence to Bridget Kaufman BA, MD .

Editor information

Editors and Affiliations

  1. Medstar Georgetown University Hospital, Washington, District of Columbia, USA

    Allen J. Taylor

1 Electronic Supplementary Material

Video 9.1

MR in setting of presumptive ARF (Provided by Robin Winkler Doroshow, MD, Medstar Georgetown University Hospital, Washington, DC.) (MP4 1034 kb)

Video 9.2

Moderate to severe MR, as described by Dr. W. Proctor Harvey (File 149 from Clinical Cardiology by W. Proctor Harvey, MD, MACC, Jules Bedynek, MD, and David Canfield and published by Laennec Publishing Inc., Fairfield, NJ. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved.) (MP4 12513 kb)

Video 9.3

Female patient with chronic significant MR, as described by Dr. W. Proctor Harvey (File 145 from Clinical Cardiology by W. Proctor Harvey, MD, MACC, Jules Bedynek, MD, and David Canfield and published by Laennec Publishing Inc., Fairfield, NJ. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved.) (MP4 6002 kb)

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© 2015 Springer-Verlag London

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Kaufman, B., Sonne, C., Tsang, A.K. (2015). Mitral Regurgitation. In: Taylor, A. (eds) Learning Cardiac Auscultation. Springer, London. https://doi.org/10.1007/978-1-4471-6738-9_9

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  • DOI: https://doi.org/10.1007/978-1-4471-6738-9_9

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6737-2

  • Online ISBN: 978-1-4471-6738-9

  • eBook Packages: MedicineMedicine (R0)

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