Damage to valve leading to regurgitant flow into Left atrium and increased Left Atrial and Ventricular pressures and reduction in cardiac output
Annulus: LV dilatation, mitral annular calcification, endocarditis
Leaflets: Congenital, Marfan’s Syndrome, endocarditis, rheumatic heart disease,
collagen vascular disease
Chordae Tendineae: Trauma/tear, Marfan’s Syndrome, endocarditis, acute MI
Papillary Muscles & LV: Ischaemia, infarction, rupture, aneurysm, HOCM
Hyperdynamic, displaced apex beat due to LVH, soft S1, pansystolic murmur radiating to axilla, 3rd heart sound, pulmonary oedema
Dyspnoea, fatigue, orthopnoea, paroxysmal nocturnal dyspnoea
ECG: Right Atrial Enlargement (Peaked P Wave), Left Ventricular Hypertrophy
Chest X-Ray: Left Ventricular Hypertrophy, Right Atrial Enlargement, Pulmonary Hypertension
Echo: Assess for leaflet abnormalities, severity of regurgitation, LV function
Cardiac catheterisation
Medical: Asymptomatic – serial echocardiograms to monitor progress
Symptomatic - reduce preload (diuretics) and reduce afterload (ACEI)
Surgical: Mitral valve replacement.
Severe disease has a poor outlook, Heart failure, AF, Infective endocarditis
