Abstract
A 68-year-old man is referred to his family doctor for dyspnea and fatigue for ordinary activities; symptoms arose 3 months before. At the beginning, dyspnea was mild and was present only after a moderate to intense physical activity. In the last 2 weeks, the symptoms worsened until dyspnea was evident during moderate physical activity (fast walking or after few steps of stairs) with even one episode of orthopnea at night that resolved after 30 min. No chest pain at rest or during exertion was referred; there were no syncope or dizziness and no palpitations.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kumanohoso T, Otsuji Y, Yoshifuku S, Matsukida K, Koriyama C, Kisanuki A, Minagoe S, Levine RA, Tei C (2003) Mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior myocardial infarction: quantitative analysis of left ventricular and mitral valve geometry in 103 patients with prior myocardial infarction. J Thorac Cardiovasc Surg 125:135–143
Otto CM (2001) Evaluation and management of chronic mitral regurgitation. N Engl J Med 345:740
Marcus RH, Sareli P, Pocock WA, Barlow JB (1994) The spectrum of severe rheumatic mitral valve disease in a developing country. Correlations among clinical presentation, surgical pathologic findings, and hemodynamic sequelae. Ann Intern Med 120:177–183
Tibayan FA, Rodriguez F, Zasio MK, Bailey L, Liang D, Daughters GT, Langer F, Ingels NB, Miller DC (2003) Geometric distortions of the mitral valvular-ventricular complex in chronic ischemic mitral regurgitation. Circulation 108(Suppl 1):II116–II121
Izumi S, Miyatake K, Beppu S et al (1987) Mechanism of mitral regurgitation in patients with myocardial infarction: a study using real-time two-dimensional Doppler flow imaging and echocardiography. Circulation 76:777–785
Yellin EL, Yoran C, Sonnenblick EH, Gabbay S, Frater RW (1979) Dynamic changes in the canine mitral regurgitant orifice area during ventricular ejection. Circ Res 45:677–683
Enriquez-Sarano M, Seward JB, Bailey KR, Tajik AJ (1994) Effective regurgitant orifice area: a noninvasive Doppler development of an old hemodynamic concept. J Am Coll Cardiol 23:443–451
Yoran C, Yellin EL, Becker RM, Gabbay S, Frater RW, Sonnenblick EH (1979) Dynamic aspects of acute mitral regurgitation: effects of ventricular volume, pressure and contractility on the effective regurgitant orifice area. Circulation 60:170–176
Keren G, Bier A, Strom JA, Laniado S, Sonnenblick EH, LeJemtel TH (1986) Dynamics of mitral regurgitation during nitroglycerin therapy: a Doppler echocardiographic study. Am Heart J 112:517–525
Braunwald E, Awe WC (1963) The syndrome of severe mitral regurgitation with normal left atrial pressure. Circulation 27:29–35
Enriquez-Sarano M, Tajik AJ, Schaff HV et al (1994) Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications. J Am Coll Cardiol 24:1536–1543
Crawford MH, Souchek J, Oprian CA et al (1990) Determinants of survival and left ventricular performance after mitral valve replacement. Department of Veterans Affairs Cooperative Study on Valvular Heart Disease. Circulation 81:1173–1181
Urabe Y, Mann DL, Kent RL et al (1992) Cellular and ventricular contractile dysfunction in experimental canine mitral regurgitation. Circ Res 70:131–147
He S, Fontaine AA, Schwammenthal E, Yoganathan AP, Levine RA (1997) Integrated mechanism for functional mitral regurgitation: leaflet restriction versus coapting force: in vitro studies. Circulation 96:1826–1834
Otsuji Y, Handschumacher MD, Schwammenthal E et al (1997) Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation: direct in vivo demonstration of altered leaflet tethering geometry. Circulation 96:1999–2008
Enriquez-Sarano M, Tajik AJ, Bailey KR, Seward JB (1993) Color flow imaging compared with quantitative Doppler assessment of severity of mitral regurgitation: influence of eccentricity of jet and mechanism of regurgitation. J Am Coll Cardiol 21:1211–1219
Glick BN, Roberts WC (1992) Usefulness of total 12-lead QRS voltage in diagnosing left ventricular hypertrophy in clinically isolated, pure, chronic, severe mitral regurgitation. Am J Cardiol 70:1088–1092
Lancellotti P et al (2013) Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 14:611–644
Tribouilloy C, Shen WF, Quéré JP, Rey JL, Choquet D, Dufossé H et al (1992) Assessment of severity of mitral regurgitation by measuring regurgitant jet width at its origin with transesophageal Doppler color flow imaging. Circulation 85:1248–1253
Enriquez-Sarano M, Miller FA Jr, Hayes SN, Bailey KR, Tajik AJ, Seward JB (1995) Effective mitral regurgitant orifice area: clinical use and pitfalls of the proximal isovelocity surface area method. J Am Coll Cardiol 25:703–709
Enriquez-Sarano M, Dujardin KS, Tribouilloy CM, Seward JB, Yoganathan AP, Bailey KR et al (1999) Determinants of pulmonary venous flow reversal in mitral regurgitation and its usefulness in determining the severity of regurgitation. Am J Cardiol 83:535–541
Mauri L et al (2013) 4-year results of a randomized controlled trial of percutaneous repair versus surgery for mitral regurgitation. J Am Coll Cardiol 62(4):317–328. doi:10.1016/j.jacc.2013.04.030
Suri RM, Schaff HV, Dearani JA et al (2006) Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg 82:819
Enriquez-Sarano M, Akins CW, Vahanian A (2009) Mitral regurgitation. Lancet 373:1382–1394
Seneviratne B, Moore GA, West PD (1994) Effect of captopril on functional mitral regurgitation in dilated heart failure: a randomised double blind placebo controlled trial. Br Heart J 72:63
Van Bommel RJ et al (2011) Cardiac resynchronization therapy as a therapeutic option in patients with moderate-severe functional mitral regurgitation and high operative risk. Circulation 124:912
Brandt RR, Reiner C, Arnold R et al (2006) Contractile response and mitral regurgitation after temporary interruption of long-term cardiac resynchronization therapy. Eur Heart J 27:187
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Flori, M., Scappini, L., Piangerelli, L. (2015). Mitral Regurgitation. In: Capucci, A. (eds) Clinical Cases in Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-19926-9_16
Download citation
DOI: https://doi.org/10.1007/978-3-319-19926-9_16
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-19925-2
Online ISBN: 978-3-319-19926-9
eBook Packages: MedicineMedicine (R0)