mitral regurgitation

1. MITRAL REGURGITATION –
PATHOPHYSIOLOGY
Dr Kunwar Sidharth
VMMC & SJH

2. DEFINITION
• Defined as abnormal reversal of blood from LV
 LA
• Caused by disruption in any part of the mitral
valve apparatus.
• Can be divided into 3 stages –
– Acute
– Chronic compensated
– Chronic decompensated

5. MR ETIOLOGY
• PRIMARY – “ VALVE MAKES THE HEART
SICK”
• SECONDARY – “HEART MAKES THE VALVE
SICK “

6. MR ETIOLOGY

7. MR ETIOLOGY
• ACUTE MR
– PAPILLARY MUSCLE DYSFUNCTION – USUALY 2-7
DAYS AFTER MI
– CHORDAE TENDINAE RUPTURE
• CHRONIC MR

8. MYXOMATOUS DEGENERATION
• MITRAL VALVE COMPOSED OF –
– ZONA SPOGIOSA – OUTER SPONGY LAYER
– ZONA FIBROSA – INNER FIBROUS LAYER
• IN THIS, THE FIBROUS LAYER BECOMES WEAK

12. NEUROHORMONAL MALADAPTIVE
RESPONSES

16. SIGNS AND SYMPTOMS

19. MURMURS

20. Murmurs

25. 2D ECHO
• INDICATIONS –
– ALL DIASTOLIC MURMURS
– FOR SYSTOLIC MURMUR GRADE 3-6

30. TREATMENT
• MEDICAL
• SURGICAL –
– REPAIR
– REPLACEMENT

31. TO BE CONTINUED WITH CASE
PRESENTATION
• HISTORY TAKING
• GENERAL EXAMINATION
• 2D ECHO RECORDINGS
• ECG CHANGES
• CRITERIA FOR SURGICAL INTERVENTION.

32. THANKS