Systolic backflow from LV to LA.
Causes
- • Primary (degenerative, endocarditis, rheumatic)
- • Secondary (functional/ischaemic, LV dilatation)
Clinical features
- • Dyspnoea, fatigue, palpitations (AF), acute pulm oedema if rupture
Examination
- • Pansystolic murmur at apex radiating to axilla
- • Displaced apex
- • S3
Investigations
- • Echo (severity, mechanism, LV size, EF)
- • TOE for surgical planning
- • BNP
Management
- • Primary severe symptomatic → MV repair (preferred) or replacement
- • Secondary → optimise HF Rx first; consider transcatheter edge-to-edge repair (COAPT criteria)
- • Acute severe MR → emergency surgery + IABP bridge
Complications
- • HF, AF, pulmonary HTN, endocarditis
References
- • ESC/EACTS 2021 Valvular
Educational — verify locally.
