Mitral regurgitation is the abnormal reversal of blood from the left ventricle to the left atrium, caused by disruption of the mitral valve apparatus. It can be divided into acute, chronic compensated, and chronic decompensated stages. The etiology includes primary causes where the valve itself is abnormal, and secondary causes where the heart problem leads to valve dysfunction. Diagnosis is typically made using a 2D echocardiogram to visualize the valve and assess the severity and cause of regurgitation. Treatment options involve medical management or surgical repair or replacement of the valve.

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