Q. Symptoms of mitral regurgitation?

Symptoms depend upon underlying etiology of mitral regurgitation. Patients with mild mitral regurgitation and most of those with even severe mitral regurgitation are asymptomatic. However, patients with secondary mitral regurgitation due to ischaemic heart disease or dilated cardiomyopathy will usually be symptomatic of their underlying myocardial failure. Patients usually have dyspnoea on effort, palpitations and fatigue. Worsening symptoms usually denote worsening of underlying left ventricular dysfunction. Conversely left ventricular dysfunction may progress without any symptoms. Symptoms correlate more with hemodynamic status than severity of mitral regurgitation. Patients may also be asymptomatic as they gradually limit their physical activity. Patients with mitral valve prolapse may complain of chest pain. Sudden worsening of symptoms in a stable patient usually indicates chordal rupture or endocarditis. Decompensation due to superimposed hemodynamic burden or onset of atrial fibrillation may sometimes bring chronic mitral regurgitation to the clinical notice. Sometimes patients who present with severe symptoms may slowly settle down due to dilatation of left atrium with increased compliance. Symptoms of edema feet denoting right heart failure are usually a late feature.