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.

2. Mitral valve replacement.