1.Define :Primary MR is characterized by pathology of the valvular apparatus, to include the leaflets, chordae, papillary muscles, or annulus. Secondary regurgitation typically results from left ventricular (LV) dysfunction, which alters LV wall motion and geometry, tethering the leaflets and causing malcoaptation. The amount of regurgitant volume that may cause adverse outcomes differs between primary and secondary MR; amounts that would be considered only “moderate” in a case of primary MR may be “severe” when the etiology is secondary.
2.Severe primary mitral regurgitation :The rule of 567=5:Regurgitation fraction is 50% or more;6 :Regurgitation volume is 60 ml or more and 7:Vena contracta is 0.7 or more .
3.Acute severe may be faintly audible or not at all audible because of very high left atrial pressure.There during PBMV auscultate for residual MS but not for appearance of severe MR (Pressure tracing,ECHO and symptom would tell).
Severe MR[Rule of 4,5,6,7]
Vena contracta of the mitral regurgitation jet ≥0.7 cm
Regurgitant volume ≥60 ml
Regurgitant fraction ≥50%
Effective regurgitant orifice area of ≥0.4 cm2
LV dilation
2.Severe primary mitral regurgitation :The rule of 567=5:Regurgitation fraction is 50% or more;6 :Regurgitation volume is 60 ml or more and 7:Vena contracta is 0.7 or more .
3.Acute severe may be faintly audible or not at all audible because of very high left atrial pressure.There during PBMV auscultate for residual MS but not for appearance of severe MR (Pressure tracing,ECHO and symptom would tell).
Severe MR[Rule of 4,5,6,7]
Vena contracta of the mitral regurgitation jet ≥0.7 cm
Regurgitant volume ≥60 ml
Regurgitant fraction ≥50%
Effective regurgitant orifice area of ≥0.4 cm2
LV dilation
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