What Is Wrong with This MR: Part I

Abstract

Mitral regurgitation (MR) is a common valve disease, frequently encountered in echocardiography laboratories. Correct quantification of the severity of the MR is of paramount importance for accurate prognostication and proper treatment planning. The MR spectral Doppler tracing can provide important information regarding intracardiac pressures and be a clue to the presence of various cardiovascular pathologies. Assessing the MR jet velocity is essentially unrelated to the MR severity. Severity is determined by the quantity of the MR—the volume (or fraction) of blood that spills back into the LA instead of being ejected forward through the aortic valve. MR velocity is determined by the pressure gradient driving this velocity, irrespective of the volume of blood that regurgitates back into the LA. Analyzing MR spectral Doppler can provide a clue to the presence of various cardiac (or extra-cardiac) pathologies, and presence of an unusual MR spectral tracing should prompt a search for its cause.