Page 116 - Clinical Pearls in Cardiology

104 Clinical Pearls in Cardiology

guidelines advocate surgical intervention in the form of
heart transplantation, rather than mitral annuloplasty,
in patients with severe functional MR and depressed
left ventricular function, who are symptomatic despite
maximal medical therapy for heart failure (Ref: Heart.
BMJ. 2011;97:1012–23).
8. What are the important differentiating features
between acute and chronic mitral regurgitation?
The important features that help to distinguish acute
mitral regurgitation from chronic mitral regurgitation
are the following (Table 1).
Table 1: Distinction between acute mitral regurgitation
and chronic mitral regurgitation
Chronic MR Acute MR
Chronic MR Chronic MR Chronic MR
(Rheumatic) (Functional) (MVP)
Usually occurs Is the result Due to the Due to the
as the sequale of annular floppy mitral ischemic
of past attack dilatation valve in mitral rupture of
of rheumatic secondary to valve prolapse chordae
fever the dilatation or papillary
of the left muscle
ventricle
Isolated MR is Valve cusps May be due to Due to the
rare are normal the contractile perforation
dysfunction of of the valve
the postero- cusps in
medial papillary endocarditis
muscle in
chronic Due to blunt
myocardial chest trauma
ischemia

Contd...