Please enable JavaScript.

Coggle requires JavaScript to display documents.

Mitral Regurgitation (Examination (Precordium (Murmur (Blowing PSM, Apex,…

- - - - Volume overload as ventricle has to pump
        forward SV and regurgitant volume
      - → eccentric hypertrophy
    - - Soft S1
      - S2 not heard separately from murmur
      - ± loud P2 (if PTH)
    - - Blowing PSM
      - Apex
      - Left lateral position in end expiration
      - Radiates to the axilla
- - - - LA and LV hypertrophy
      - Mitral valve calcification
      - Pulmonary oedema
    - - Severity
      - LV function
      - Other valve function
      - Echo Features of Severe MR (AHA 2006)
        
        Jet width >0.6cm
        
        Systolic pulmonary flow reversal
        
        Regurgitant volume >60ml
    - - Assess coronaries (needed if surgery planned)
  - - - AF: rate control and anticoagulate
      - Emboli: anticoagulate
      - ↓ afterload
        
        ACEi or β-B (esp. carvedilol)
        
        Diuretics
    - - Valve replacement or repair
      - Aim to replace the valve before significant LV dilation and dysfunction.
      - Indications ~ Symptomatic
    - - Often asymptomatic for >10yrs
      - Symptomatic: 25% mortality @ 5yrs