Different mechanisms for diastolic mitral regurgitation illustrated by three comparative cases

Echocardiography. 2011 Apr;28(4):476-9. doi: 10.1111/j.1540-8175.2010.01323.x. Epub 2011 Mar 14.

Abstract

Diastolic mitral regurgitation (DMR) has been reported in patients with AV block, aortic regurgitation, cardiomyopathies, and in patients with long filling periods in atrial tachyarrhythmias. The mechanism for DMR is a reversal in the atrioventricular gradient during diastole. However, because of its relatively low velocity, it may be difficult to diagnose noninvasively. We present three different cases of diastolic MR in 2:1 second-degree AV block, atrial flutter, and dilated cardiomyopathy, with different locations in diastole. Diastolic tricuspid regurgitation commonly accompanies DMR. Careful analysis of echocardiographical images related with online ECG is very important in order to delineate systolic and DMR, and their timing in systole and diastole.

Publication types

  • Case Reports

MeSH terms

  • Atrial Flutter / complications*
  • Atrial Flutter / diagnostic imaging
  • Atrial Flutter / physiopathology
  • Atrioventricular Block / complications*
  • Atrioventricular Block / diagnostic imaging
  • Atrioventricular Block / physiopathology
  • Cardiomyopathy, Dilated / complications*
  • Cardiomyopathy, Dilated / diagnostic imaging
  • Cardiomyopathy, Dilated / physiopathology
  • Diastole
  • Echocardiography, Doppler, Color*
  • Electrocardiography
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / diagnostic imaging*
  • Mitral Valve Insufficiency / etiology*
  • Mitral Valve Insufficiency / physiopathology