mitral regurgitation (MR)
Jump to navigation
Jump to search
Classification
Pathology
- abnormal systolic back flow of blood from the left ventricle into the left atrium, resulting from imperfect closure of the mitral valve
Clinical manifestations
Diagnostic procedures
- transthoracic echocardiagram
- regurgitant oriface area
- regurgitant volume
- regurgitant fraction
- transesophageal echocardiogram (TEE) if transthoracic echocardiogram (TTE) inadequate[3][6]
- repeat echocardiography indicated when there is a change in clinical status (even if most recent echocardiogram was 3-4 months prior)[3]
Complications
- atrial fibrillation* associated with long-term mortality in patients with degenerative mitral regurgitation[9]
* paroxysmal atrial fibrillation or persistent atrial fibrillation
Management
- see acute mitral regurgitation &/or chronic mitral regurgitation
- consensus decision pathway[7]
- percutaneous repair of severe mitral regurgitation due to reduced LVEF with MitraClip device of no benefit[8]
- transcatheter mitral valve repair with 5-year advantage over medical care for patients with moderate-severe mitral regurgitation[10]
- surgery improves survival in patients with atrial fibrillation[9]
More specific terms
Additional terms
References
- ↑ Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 128-29
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 44
- ↑ 3.0 3.1 3.2 Medical Knowledge Self Assessment Program (MKSAP) 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2006, 2009, 2012, 2015, 2018, 2022
- ↑ Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
- ↑ Foster E. Clinical practice. Mitral regurgitation due to degenerative mitral-valve disease. N Engl J Med. 2010 Jul 8;363(2):156-65 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20647211
- ↑ 6.0 6.1 Solis J, Piro V, Vazquez de Prada JA, Loughlin G Echocardiographic assessment of mitral regurgitation: general considerations. Cardiol Clin. 2013 May;31(2):165-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23743069
- ↑ 7.0 7.1 O'Gara PT, Grayburn PA, Badhwar V et al 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation. A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol. Oct 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29055505 <Internet> http://www.onlinejacc.org/content/early/2017/10/16/j.jacc.2017.09.019
- ↑ 8.0 8.1 Obadia JF, Messika-Zeitoun D, Leurent G et al. Percutaneous repair or medical treatment for secondary mitral regurgitation. N Engl J Med 2018 Aug 27 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30145927 Free full text https://www.nejm.org/doi/10.1056/NEJMoa1805374
- ↑ 9.0 9.1 9.2 Grigioni F, Benfari G, Vanoverschelde JL et al. Long-term implications of atrial fibrillation in patients with degenerative mitral regurgitation. J Am Coll Cardiol 2019 Jan 29; 73:264-274 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30678755 https://www.sciencedirect.com/science/article/pii/S0735109718392131
- ↑ 10.0 10.1 Stone GW et al. Five-year follow-up after transcatheter repair of secondary mitral regurgitation. N Engl J Med 2023 Mar 5; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/36876756 https://www.nejm.org/doi/10.1056/NEJMoa2300213