Primary and Secondary Causes of Mitral Regurgitation
Primary (organic) chronic mitral regurgitation:
 • Leaflet: Rheumatic fever, Infective endocarditis, Myxomatous (MVP), Connective tissue (Marfan, Ehlers-Danlos), Congenital (cleft, cushion defects), Systemic inflammation (SLE, Scleroderma)
 • Chordae tendineae: Rheumatic fever, Infective endocarditis, Myxomatous (MVP), Spontaneous rupture
 • Mitral annulus: Rheumatic fever, Calcification (idiopathic), Myxomatous (MVP), Connective tissue (Marfan, Ehlers Danlos)
 • Prosthetic valve: Paravalvular leak, Infective endocarditis, Ring fracture, Thrombus formation, Leaflet deterioration, Occluder dysfunction
Secondary (functional) chronic mitral regurgitation:
 • Leaflet: Hypertrophic cardiomyopathy, Drug-related
 • Chordae tendineae: Myocardial infarction, Tendineae rupture
 • Papillary muscle: Myocardial infarction, Dilated cardiomyopathy, Papillary muscle rupture, Left ventricular aneurysm
 • Mitral annulus valve: Dilated cardiomyopathy

- VA Joint Chiefs @BostonChiefs

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