130. Going Backwards – An Approach to Mitral Regurgitation

Mitral regurgitation (MR) and its various clinical presentations are discussed, beginning with the basic valve anatomy and causes of MR, including primary MR due to valve apparatus failure and secondary MR from LV dysfunction. Acute MR can lead to pulmonary edema, while chronic MR results in LV dilation. The approach to MR involves assessing clinical stability through vital signs and physical exams, noting that murmurs may be absent in acute cases. Workup includes chest X-rays, electrolytes, ECGs, and echocardiography to evaluate MR severity and etiology. Treatment strategies range from urgent surgical repair for acute MR to medical management for chronic MR, with afterload reduction as a key component.