Mitral Regurgitation

Backflow

Step 1: View clinicals

A 70 year old man presents with exertional dyspnea and palpitations for 2 months. He was diagnosed with mitral valve prolapse at the age of 35 years, for which no interventions were performed. He defaulted on followup many years ago. His medical history is otherwise unremarkable.


Step 2: Order all relevant investigations

Echocardiography

There is moderate mitral regurgitation, while the mitral valve is moderately myxomatous and shows holosystolic prolapse. The left ventricle is dilated, although left ventricular function is good, with an ejection fraction of 56%.

Chest X ray

The chest x-ray is significant for cardiomegaly.

ECG

The ECG is positive for atrial fibrillation and a left bundle-branch block.

Coronary angiography

The Coronary Angiogram is normal.


Step 3: Select appropriate management

Endocarditis Prophylaxis
Anticoagulation
Mitral Valve replacement
Diuretics


Score: ★★☆