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Mitral regurgitation, also known as mitral insufficiency or mitral incompetence, is the backward flow of blood from the left ventricle, through the mitral valve, and into the left atrium, when the left ventricle contracts, resulting in a systolic murmur radiating to the left armpit.
This heart sound when present in a child or young adult implies the presence of a supple ventricle that can undergo rapid filling. Conversely, when heard in a middle-aged or older adult, an S 3 is often a sign of disease, indicating increased ventricular filling due to congestive heart failure or severe mitral or tricuspid regurgitation. [6]
In severe cases, obliteration of the S2 heart sound may occur. Stenosis of Bicuspid aortic valve is like the aortic valve stenosis heart murmur. But, one may hear a systolic ejection click after S1 in calcified bicuspid aortic valves. Symptoms tend to present between 40 and 70 years of age. Mitral regurgitation is a holosystolic murmur. One can ...
The first heart sound, or S 1, forms the "lub" of "lub-dub" and is composed of components M 1 (mitral valve closure) and T 1 (tricuspid valve closure). Normally M 1 precedes T 1 slightly. It is caused by the closure of the atrioventricular valves , i.e. tricuspid and mitral (bicuspid), at the beginning of ventricular contraction, or systole .
Mitral valve prolapse: This is the most common cause of late systolic murmurs. It can be heard best over the apex of the heart, usually preceded by clicks. The most common cause of mitral valve prolapse is "floppy" valve (Barlow's) syndrome. If the prolapse becomes severe enough, mitral regurgitation may occur.
Mitral valve prolapse is frequently associated with mild mitral regurgitation, [15] where blood aberrantly flows from the left ventricle into the left atrium during systole. In the United States, MVP is the most common cause of severe, non-ischemic mitral regurgitation. [4]
Common causes include aortic or pulmonary regurgitation and left anterior descending artery stenosis. Mid-diastolic murmurs start after S2 and end before S1. They are due to turbulent flow across the atrioventricular (mitral & tricuspid) valves during the rapid filling phase from mitral or tricuspid stenosis.
Chest x-ray in mitral regurgitation can show an enlarged left atrium, as well as pulmonary venous congestion. [33] It may also show valvular calcifications specifically in combined mitral regurgitation and stenosis due to rheumatic heart disease. [33]