Education in Heart
Valvular heart diseaseIschaemic mitral regurgitation: mechanisms and diagnosis
1 University of Queensland, Princess Alexandra Hospital, Brisbane, Australia
2 University Hospital Sart Tilman, Liege, Belgium
Correspondence to:
Correspondence to Professor T Marwick, University of Queensland School of Medicine, Princess Alexandra Hospital, Ipswich Road, Brisbane, Qld 4102, Australia; t.marwick@uq.edu.au
| The first 150 words of the full text of this article appear below. |
Ischaemic mitral regurgitation (MR) is defined as MR caused by changes of left ventricular structure and function related ultimately to ischaemia. However, the acute manifestation of MR following infarction (which usually presents as a haemodynamic crisis) is related to rupture or stretching of the papillary muscle, and is normally categorised with complications of infarction. The term ischaemic MR is usually understood to relate to chronic MR, occurring >2 weeks after infarction and in the absence of structural mitral valve disease. In terms of pathogenesis, this should be considered a disease of abnormal left ventricular (LV) shape and function with a valvular manifestation.
The frequency in ischaemic MR varies according to the technique used for its detection (being more common in echocardiographic than angiographic studies), the management of the patients (more common in non-revascularised patients), the timing post-myocardial infarction (MI) (more common early, before medical treatment is optimised),
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