Mitral regurgitation (MR)

Written by Dr.Md.Redwanul Huq (Masum)
Sunday, 17 March 2013 12:16

Symptoms of Mitral regurgitation:

  • May be asymptomatic
  • Weakness
  • Palpitation
  • Exertional dyspnoea.

Signs of Mitral regurgitation:

  • Shifted apex beat
  • Apical impulse- heaving in nature
  • Systolic thrill
  • First heart sound may be soft
  • Second heart sound is normally split and diminished
  • Cardiomegaly
  • Pansystolic murmur which is best heard at the apex in left decubitus position and radiating with equal intensity to axilla and back.

Complications of Mitral regurgitation:

  • Congestive cardiac failure (CCF)
  • Infective endocarditis
  • Atrial fibrillations
  • Atrial flutter
  • Ventricular extrasystole
  • Pulmonary hypertension.

Investigations for Mitral regurgitation:

  • Chest X-ray
  • ECG-Left ventricular hypertrophy, Left atrial hypertrophy
  • Echocardiography.

Differential diagnosis of Mitral regurgitation:

  • ASD (Atrial Septal Defect)
  • Mitral valve prolapse.

Treatment of Mitral regurgitation:

I. Medical treatment:

  • Mild with no symptom-no treatment of mitral regurgitation
  • Diuretics
  • Digoxin
  • Treatment of complications of mitral regurgitation, e.g.CCF, Infective endocarditis
  • Prophylaxis in cases of-Rheumatic fever, antibiotic against Infective endocarditis, maintenance of dental hygiene.

II. Surgical treatment:

  1. Mitral valve surgery-

– Intractable CCF
– Pulmonary hypertension
– Progressive cardiomegaly with symptoms.

  1. Mitral valve replacement.