Mitral regurgitation — Study Path Agent

Chapter 1

Mitral valve anatomy & normal physiology

1

Mitral valve apparatus: leaflets, annulus, chordae, papillary muscles

2

Cardiac cycle basics relevant to MR (systole, LV/LA pressures)

3

Left atrium & left ventricle structure and function

Chapter 2

Etiology & classification of mitral regurgitation

4

Acute MR causes: papillary muscle rupture, chordal rupture, endocarditis

5

Mixed/other etiologies: rheumatic disease, congenital, annular calcification

Chapter 3

Pathophysiology & hemodynamics

6

Acute vs chronic MR: compensation, LA/LV remodeling

7

Volume overload physiology: forward vs regurgitant stroke volume

8

Pulmonary venous hypertension and pulmonary hypertension in MR

9

Atrial fibrillation and its relationship to MR/LA dilation

Chapter 4

Clinical presentation & physical examination

10

Symptoms by stage: exertional dyspnea, fatigue, orthopnea, edema

11

Key murmur features: holosystolic murmur, radiation, changes with maneuvers

12

Associated exam findings: S3, displaced PMI, rales, signs of right HF

13

Differential diagnosis of systolic murmurs (TR, VSD, AS)

Chapter 5

Diagnosis & imaging workup

14

Transthoracic echo (TTE): core assessment of MR mechanism and severity

2 subtopics

15

Color Doppler and jet interpretation basics (limitations and pitfalls)

16

Quantification essentials: vena contracta, PISA/EROA, regurgitant volume/fraction

17

Transesophageal echo (TEE): when to use and what it adds

18

Exercise/stress echo for symptoms and dynamic MR

19

Cardiac MRI and CT: role in MR quantification and pre-procedural planning

20

Risk stratification: LV size/function, LA size, pulmonary pressures, biomarkers

Chapter 6

Management, interventions & follow-up

21

Medical therapy principles (symptom control; treating HF, HTN, AF)

22

When to refer: indications for valve intervention and timing concepts

23

Surgical options: mitral repair vs replacement, expected outcomes

24

Transcatheter edge-to-edge repair (TEER) and other catheter-based therapies

25

Special scenario: acute severe MR (stabilization and urgent intervention)

26

Post-intervention care: anticoagulation/antiplatelet, endocarditis prevention

27

Follow-up strategy: surveillance echo intervals and symptom monitoring