Mitral Regurgitation
Cardiovascular · ~11% of blueprint- Pathophysiology
- Incompetent mitral valve → systolic backflow LV→LA → LA/LV volume overload → dilation, AFib, eventual HF. Causes: MVP, ischemic papillary rupture, rheumatic, endocarditis.
- Signs & Symptoms
- Holosystolic murmur at apex radiating to axilla; dyspnea, fatigue, S3, displaced PMI. Acute (papillary rupture) → flash pulmonary edema & shock.
- Gold Standard Diagnosis
- Echocardiography (severity, mechanism, EF, LA size).
- First-line Treatment
- Surgical or transcatheter repair/replacement for severe/symptomatic disease. Acute severe = surgical emergency; afterload reduction (nitroprusside) as a bridge.
High-Yield Pearl
Acute MR from post-MI papillary muscle rupture is a can't-miss cause of a new murmur + cardiogenic shock.
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Sources
Reviewed September 2026- 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease — ACC/AHA, 2020
- StatPearls: Mitral Regurgitation — NCBI Bookshelf / StatPearls, 2025
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