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Clinical manifestations and diagnosis of chronic mitral regurgitation

Catherine M Otto, MD
Section Editors
William H Gaasch, MD
Warren J Manning, MD
Deputy Editor
Susan B Yeon, MD, JD, FACC


Mitral regurgitation (MR) is a common valvular disorder that can arise from abnormalities of any part of the mitral valve apparatus. These include the valve leaflets, annulus, chordae tendineae, and papillary muscles (table 1 and figure 1). The left atrium and ventricle are also integrally involved with mitral valve function.

The etiology and clinical manifestations of chronic MR will be reviewed here. Issues related to acute MR, pathophysiology of chronic MR and management of chronic MR are discussed separately. (See "Acute mitral regurgitation in adults" and "Pathophysiology of chronic mitral regurgitation" and "Management of chronic primary mitral regurgitation" and "Management and prognosis of chronic secondary mitral regurgitation".)


Mitral regurgitation (MR) may be due to a primary abnormality (sometimes referred to organic MR) of one or more components of the valve apparatus (leaflets, chordae tendineae, papillary muscles, and/or annulus) or may be secondary (previously referred to as functional MR) to another cardiac disease (such as coronary heart disease or a cardiomyopathy) (table 1). (See "Pathophysiology of chronic mitral regurgitation", section on 'Causes and mechanisms'.)

The causes of primary MR include:

Degenerative mitral valve disease (including mitral valve prolapse) is the most common cause of primary MR in developed countries. It includes a spectrum of disease ranging from myxomatous mitral valve disease (also known as myxomatous degeneration, with redundancy of anterior and posterior mitral leaflets and the chordae), seen primarily in younger populations, and fibroelastic deficiency disease, seen primarily in older populations. It is not clear if these are two distinct disease processes or manifestations of a single disease. (See "Definition and diagnosis of mitral valve prolapse" and "Nonarrhythmic complications of mitral valve prolapse".)

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Literature review current through: Nov 2017. | This topic last updated: Aug 18, 2017.
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