7th March 2024

Mitral Regurgitation

Mitral regurgitation (MR) may present with dyspnoea, usually on exertion, palpitations, and/or decreased exercise tolerance. It typically presents as a holosystolic blowing murmur at the apex, radiating to the axilla. 

A transthoracic echocardiogram is the diagnostic test of choice in identifying the presence, severity, and mechanism of MR. Colour Doppler flow and continuous-wave Doppler studies can assess the severity of regurgitation, left ventricular dimensions, size and function of the right ventricle, and pulmonary artery systolic pressure. 

Surgical treatment is the best available treatment option, although percutaneous approaches have gained significant potential. Asymptomatic chronic MR with LVEF, more than 60% are treated with ACEi and beta blockers. All patients with MR may be offered antibiotic prophylaxis prior to dental and/or urological procedures, depending on their risk profiles. The most common complications of MR include AF, pulmonary hypertension, LV dysfunction, CCF and prosthesis stenosis.