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Ischemic mitral regurgitation

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


Ischemic mitral regurgitation (MR) is a complication of coronary heart disease, and its broad definition includes a spectrum of disorders including chronic MR post myocardial infarction (MI), acute MR (or acute worsening of MR) with acute MI (ST elevation or non-ST elevation), and reversible MR due to myocardial ischemia.

An overview of the presentation and management of patients with ischemic MR is presented here, with most of the discussion focused on chronic functional ischemic MR. Acute MR in the setting of acute MI including MR caused by papillary muscle rupture is discussed separately. (See "Mechanical complications of acute myocardial infarction" and "Acute mitral regurgitation in adults".)


Most studies of ischemic mitral regurgitation (MR) have focused on chronic post-infarction MR rather than acute MR in the setting of acute myocardial infarction (MI) or reversible MR caused by acute ischemia. Thus, the term "ischemic MR" is used by primarily to indicate chronic functional post-infarction MR.

MR caused by coronary artery disease can be classified by the mechanism of the valve dysfunction [1,2]:

The vast majority of patients with ischemic MR have "functional" or "secondary" MR post MI. Thus, a better term for this condition might be "post-infarction" MR. Focal and/or global left ventricular systolic dysfunction and adverse left ventricular remodeling causes restricted leaflet motion and failure of leaflet coaptation [3].


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Literature review current through: Jan 2016. | This topic last updated: Nov 30, 2015.
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