Topic Reviews A-Z
Primary Mitral Regurgitation
Primary mitral regurgitation results from actual disease of the mitral valve apparatus.
The mitral valve leaflets, annulus, papillary muscles and chordae tendinae must interact properly for the mitral valve to function properly. Thus, disruption of any of these structures can result in primary mitral regurgitation.
The etiologies of mitral regurgitation (MR) are diverse since the mitral valve apparatus is complex. MR can occur when the mitral valve apparatus is itself diseased (primary MR) or in the absence of any abnormality of the mitral valve apparatus (secondary MR). The causes of primary and secondary MR are listed in the table below.
|
Primary MR |
Secondary MR |
|
Myxomatous changes (MVP) Rheumatic heart disease (RHD) Endocarditis Collagen vascular disease Papillary muscle dysfunction Mitral annular calcification (MAC) Spontaneous chordal rupture Trauma |
Ischemic cardiomyopathy Dilated cardiomyopathy Hypertrophic cardiomyopathy Left atrial dilation |
Secondary MR occurs when the left atrium or left ventricle dilates causing the mitral valve annulus to also dilate thus preventing the mitral valve leaflets from properly coapting. There are many causes of left atrial and left ventricular dilation and the treatment of this type of MR is directed at the primary cause. For example, if a patient develops systolic heart failure with a dilated left ventricle resulting in secondary MR, treatment would be directed at the improvement of the heart failure.