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What are the clinical signs in mitral regurgitation?

Mitral regurgitation is associated with following clinical findings
Pulse : Normal or hyperkinetic pulse, Atrial fibrillation may be present, normal pulse pressure
JVP : Normal or raised
Apex beat : Forceful
Apical systolic thrill is felt
Late left parasternal heave
Soft S-1
Loud P2 (if PAH+)
Left ventricular S3
Flow murmur (MDM) at mitral area
High pitched blowing pansystolic murmur is heard in mitral area that is conducted to axilla / base of heart

Describe  the pulse in mitral regurgitation
In mild MR – Normal
Moderate to severe MR -  Hyperkinetic
Irregulary irregular in atrial fibrillation
Peripheral pulse may be absent in embolism due to atrial fibrillation.
Describe the JVP in mitral regurgitation
Usually normal
Prominent a wave is seen in PAH (pulmonary artery hypertension); prominent V wave seen in tricuspid regurgitation
Describe the apex beat in mitral regurgitation
Usually apex beat is forceful in MR. In moderate to severe MR due to associated cardiomegaly apex beat is shifted down and out.
Describe the type of LPH (left parasternal heave) in MR
Enlarged left atrium produce late systolic lift and pulmonary artery hypertension produce pansystolic lift.

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