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Mitral Regurgitation

* Etiology: Rheumatic fever, Papillary muscle dysfunction, ruptured chordae tendenae, myxomatous degen. of MV & Endocarditis 
* SG cath shows V waves: 
- represent regurgitant flow into left atrium;
* Physical Exam: 
- Pansystolic murmur loudest at the apex, 
- MV click, S3 (more likely w/ severe MR), S4 
- Jugular A and/or V waves 
* Sequelae and Symptoms: 
- Palpatations 
- CHF, dyspnea, resp. distress (more severe w/ Acute MR); 
- w/ severe regurgitation may get pulmonary hypertension 
- Endocarditis (consider prophylaxis) 
- A. fib; 
* Afterload Therapy may benefit CO in M.R.