THE CONTEXT
Clinical findings in mitral regurgitation reflect abnormal flow, chamber enlargement, congestion and heart failure.
Symptoms and their causes
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Pulmonary congestion causes breathlessness, while low cardiac output causes fatigue.
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Right heart failure causes oedema and ascites.
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Atrial fibrillation causes palpitation.
Chamber changes and auscultation
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Atrial dilation is associated with atrial fibrillation, and cardiomegaly produces a displaced apex beat.
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The apical pansystolic murmur results from regurgitation of blood from the left ventricle to the left atrium.
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Incomplete valve closure produces a soft first heart sound.
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Rapid flow of blood into the left ventricle produces an apical third heart sound.
Congestion and right-sided findings
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Crepitations, pulmonary oedema and pleural effusions are listed among the clinical signs.
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Pulmonary hypertension causes a right ventricular heave.
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Right heart failure causes raised jugular venous pressure and oedema.