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Heart valve disease (mitral valve disease): mitral regurgitation 

Heart valve disease (mitral valve disease): mitral regurgitation
Chapter:
Heart valve disease (mitral valve disease): mitral regurgitation
Author(s):

Patrizio Lancellotti

, Raluca Dulgheru

, Mani Vannan

, and Kiyoshi Yoshida

DOI:
10.1093/med/9780198726012.003.0036
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date: 29 September 2020

Mitral regurgitation (MR) is increasingly prevalent in Europe. Echocardiography has a key role in the diagnosis and management of patients with MR. Each echocardiographic study in patients with MR should aim to characterize mitral valve morphology, identify the mechanism of valve dysfunction, quantify the severity of MR, and give hints regarding the aetiology of the disease affecting the valve. Assessment of MR severity should be based on a step-wise approach including two-dimensional-derived Doppler data and, when available, data derived from three-dimensional echocardiography. MR assessment by quantitative methods should be implemented in each patient when possible. It is imperative not only to quantify the MR severity, but also to assess its consequences on the left ventricle, left atrium, and pulmonary vascular bed and to put everything into the clinical context (presence of symptoms, individual risk assessment, etc.) before taking any decision to correct the valvular incompetence. A rigorous echocardiographic study and a correct interpretation in the individual clinical context are needed to decide if the patient should be operated on or followed up closely. Exercise stress echocardiography, when appropriate, should be part of the evaluation algorithm in patients with both primary and secondary MR, as it has proved to be useful in individual risk stratification.

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