Epidemiology
Etiology
Primary MR (organic): mitral regurgitation caused by direct involvement of the valve leaflets or chordae tendinae
Secondary MR (functional): caused by changes of the left ventricle that lead to valvular incompetence
Coronary artery disease or prior myocardial infarction causing papillary muscle involvement
This results in hypokinesis and outward displacement of the papillary muscle, creating increased tension on the attached chordae tendineae and preventing complete closure of the corresponding mitral valve cusp.
Dilated cardiomyopathy (e.g., peripartum cardiomyopathy) and left-sided heart failure
Pathophysiology
Clinical features
Auscultation
S3 heart sound in advanced stages of disease
Indication of severity vs S2-opening snap interval in Mitral stenosis , also a indication of severity
Holosystolic murmur (high-pitched, blowing)
Radiates to the left axilla and heard best over the apex (5th intercostal space at the left midclavicular line)
Intensity can be increased by increasing preload (e.g., leg raise) or afterload (e.g., handgrip) due to increased regurgitation.
Diagnostics
Treatment