Mitral regurgitation refers to leaking of the mitral valve during systole such that blood returns to the left atrium from the left ventricle.
Sound: Pansystolic murmur
Loudest region: Mitral area (5th intercostal space, mid-clavicular line)
Pansystolic murmur. Source: University of Michigan Murmur library
- Rheumatic fever
- Connective tissue disease
- Mitral valve prolapse
- Congenital abnormality
Functional regurgitation occurs due to a left ventricular abnormality, such as abnormal shape, rather than mitral valve pathology.
- Ischaemic heart disease
- Dilated cardiomyopathy
- ECG: may show atrial fibrillation and p-mitrale (broad, bifid P waves)
- Chest x-ray
- Blood cultures, if considering infective endocarditis
Medically manage underlying heart failure and atrial fibrillation.
Surgical management should be offered to symptomatic patients or those with a reduced ejection fraction.