Mitral regurgitation differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Common Causes of Mitral Regurgitation

Chronic Mitral Regurgitation

The most common cause of mitral regurgitation is mitral valve prolapse (MVP), which in turn is caused by myxomatous degeneration.[1] The most common cause of primary mitral regurgitation in the United States (causing about 50% of primary mitral regurgitation) is myxomatous degeneration of the valve. Myxomatous degeneration of the mitral valve is more common in females, and is more common in advancing age. This causes a stretching out of the leaflets of the valve and the chordae tendineae. The elongation of the valve leaflets and the chordae tendineae prevent the valve leaflets from fully coapting when the valve is closed, causing the valve leaflets to prolapse into the left atrium, thereby causing mitral regurgitation.

Ischemic heart disease causes mitral regurgitation by the combination of ischemic dysfunction of the papillary muscles, and the dilatation of the left ventricle that is present in ischemic heart disease, with the subsequent displacement of the papillary muscles and the dilatation of the mitral valve annulus.

Rheumatic fever and Marfan's syndrome are other typical causes of mitral regurgitation.[2]

Secondary mitral regurgitation is due to the dilatation of the left ventricle, causing stretching of the mitral valve annulus and displacement of the papillary muscles. This dilatation of the left ventricle can be due to any cause of dilated cardiomyopathy, including aortic insufficiency, nonischemic dilated cardiomyopathy and Noncompaction Cardiomyopathy. It is also called functional mitral regurgitation, because the papillary muscles, chordae, and valve leaflets are usually normal.[3]

Acute Mitral Regurgitation

  1. Acute bacterial endocarditis. The predominant organism is S. aureus, but varies depending upon the patient.[2]
  2. Papillary muscle rupture or dysfunction,[2] associated with ST elevation myocardial infarction

Full Differential Diagnosis of Causes of Mitral Regurgitaion

Listed alphabetically:

Complete Differential Diagnosis of the Causes of ...

(By organ system)

Cardiovascular | Cardiomyopathy | Coronary Heart Disease |Congenital mitral regurgitation | Dilation of Mitral annulus due to Heart Failure | Hypertrophic obstructive cardiomyopathy | Infective endocarditis | Left ventricular dilation | Mitral annular calcification | Mitral valve prolapse | Myocardial Infarction | Myocardial ischemia | Myxomatous degeneration | Prosthetic valve dysfunction
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Ehlers-Danlos Syndrome | Marfan Syndrome | Osteogenesis imperfecta
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease Endocarditis most often due to Staphylococcus aureus [2] | Syphilis
Musculoskeletal / Ortho Infective endocarditis
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Amyloid | Ehlers-Danlos Syndrome Rheumatic Heart Disease | Systemic Lupus Erythematosus
Sexual No underlying causes
Trauma Trauma and motor vehicle accident
Urologic No underlying causes
Miscellaneous No underlying causes

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  1. Kulick, Daniel. "Mitral Valve Prolapse (MVP)". MedicineNet.com. MedicineNet, Inc. Retrieved 2010-01-18.
  2. 2.0 2.1 2.2 2.3 Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7153-6. Chapter 1: Diseases of the Cardiovascular system > Section: Valvular Heart Disease
  3. Functional mitral regurgitation By William H Gaasch, MD. Retrieved on Jul 8, 2010
  4. British Medical Journal case reports; doi:10.1136/bcr.08.2008.0821