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Mitral Regurgitation (Causes (Mitral valve prolapse, Dilatation of LV and…
Mitral Regurgitation
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Clinical Features
Symptoms
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Palpitations (AF, increased stroke vol)
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Signs
Mild-to-moderate mitral regurgitation:
Holosystolic murmur; some murmurs are late-systolic or mid-systolic
Severe mitral regurgitation of gradual onset:
Atrial fibrillation (dilation of the left atrium)
Blood pressure normal
an enlarged left ventricle, the left ventricular cardiac apex impulse is likely to be laterally displaced, diffuse, and brief
Apical systolic thrill and holosystolic murmur
Presence of a third heart sound
Acute mitral regurgitation:
Pulmonary edema
Pulmonary hypertension with right heart failure: elevated jugular venous pulse, hepatomegaly with or without peripheral edema
Auscultation reveals either a holosystolic murmur or early systolic murmur and S3gallop
Tachycardia
Shock due to poor cardiac output
Investigation
CXR
:check: Chronic, severe MR:enlargement of left atrium and left ventricle
:check: Elevated left atrial pressure shows venous hypertension (have not reached the stage of pulmonary edema)
:check: Pulmonary edema in acute regurgitation
ECG
:check: Increased duration or amplitude of P waves points to enlargement of the left atrium; increased amplitude of QRS complex points to enlargement of the left ventricle
:check: A fibrillatory pattern indicates atrial fibrillation
Definition: defined as an abnormal reversal of blood flow from the left ventricle (LV) to the left atrium (LA). It is caused by disruption in any part of the mitral valve (MV) apparatus.