Mitral Regurgitation - Diagnosis

Diagnosis

There are many diagnostic tests that have abnormal results in the presence of mitral regurgitation. These tests suggest the diagnosis of mitral regurgitation and may indicate to the physician that further testing is warranted. For instance, the electrocardiogram (ECG) in long standing mitral regurgitation may show evidence of left atrial enlargement and left ventricular hypertrophy. Atrial fibrillation may also be noted on the ECG in individuals with chronic mitral regurgitation. The ECG may not show any of these finding in the setting of acute mitral regurgitation.

Comparison of acute and chronic phases of mitral regurgitation
Acute Chronic
Electrocardiogram Normal P mitrale, Atrial fibrillation, left ventricular hypertrophy
Heart size Normal Cardiomegaly, left atrial enlargement
Systolic murmur Heard at the base, radiates to the neck, spine, or top of head Heard at the apex, radiates to the axilla
Apical thrill May be absent Present
Jugular venous distension Present Absent

The quantification of mitral regurgitation usually employs imaging studies such as echocardiography or magnetic resonance angiography of the heart.

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