Mitral Regurgitation
Mitral regurgitation could be due to a lesion in a component of the
mitral valve apparatus, it could be due to a lesion in one of the adjacent
structures of the heart or it could be due to a systemic cause.
Hence, mitral regurgitation could be due to lesions in the:
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Papillary Muscle
Papillary muscle dysfunction
Rupture of the papillary muscle in myomalacia cordis
following myocardial infarction
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Chordae Tendinae
Rupture of the chordae tendinae due to infective
endocarditis, mitral valve prolapse, trauma, rheumatic mitral valve disease
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Valve Leaflets
Rheumatic carditis, infective endocarditis, valvotomy,
floppy mitral valves, degenerative changes
Prosthetic valve dysfunction
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Valve Ring
Left ventricular dilatation in heart failure, fibrosis,
degeneration
Paraprosthetic mitral regurgitation
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Septum
Atrial septal defect (ostium primum)
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Muscle
Hypertrophic obstructive cardiomyopathy, endomyocardial
fibrosis
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Systemic Causes
LMS Marfan’s syndrome, osteogenesis
imperfecta, systemic lupus erythematosus, rheumatic fever
IS Ehlers-Danlos syndrome, pseudoxanthoma
elasticum
Severity
of Mitral Regurgitation
The severity of mitral regurgitation may be judged clinically by the
presence of left ventricular dilatation and the presence of a third heart
sound. These features indicate more severe disease.
