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Medical and surgical management of mitral regurgitation

Management include medical and surgical modalities
Medical management include
  • Prophylaxis of IEC and RF.
  • Afterload reduction is achieved with ACE inhibitors or nifedipin
Symptomatic patient are given
  • Diurectics and digoxin in heart failure
  • In patients with atrial fibrillation
  • Drugs to reduce the heart rate is given.
  • Anti coagulation and cardioversion is given if required
  • Anticoagulants are given in patients with atrial fibrillation and embolic episodes.
Surgical options include 
Mitral valvuloplasty 
MitralValve replacement
Indications for MV repair (Valvuloplasty or annuloplasty) are the following
1.Mitral valve prolapse
2.Mitral valve annular calcification
3.Chordal rupture
4.Papillary muscle rupture
MV repair helps to maintain the annulo cardo papillary muscle continuity.
What are the indication for mitral valve replacement
Class III, IV symptoms
Severe  MR with following
1.Left ventricular ejection fraction <60
2.LV and systolic diameter >50mm by echo.