cardiovascular disorders
Mitral Regurgitation
Key Points
Common causes of mitral regurgitation (MR) include mitral valve prolapse, rheumatic fever, and left ventricular dilation or infarction. Acute MR may cause acute pulmonary edema and cardiogenic shock or sudden cardiac death. Chronic MR causes slowly progressive symptoms of heart failure and, if atrial fibrillation develops, palpitations. Typical heart sounds are a holosystolic murmur that is heard best at the apex, radiates toward the left axilla, increases in intensity with handgrip or squatting, and decreases in intensity with standing or the Valsalva maneuver. Symptomatic patients and those meeting certain echocardiographic criteria benefit from valve replacement or repair. 