Paediatric Imaging

Mitral regurgitation

incompetence of the mitral valve allowing left ventricular blood to reflux into the atrium during systole. It is often due to rheumatic heart disease but there are reported cases of isolated congenital mitral regurgitation. It is associated with endocardial cushion defects, transposition of the great arteries, endocardial fibroelastosis, hypertrophic obstructive cardiomyopathy and coronary artery or myocardial disease causing left ventricular dilatation.

The chest radiograph shows left atrial and left ventricular enlargement and pulmonary venous congestion in moderate to severe regurgitation. Pulmonary oedema may be seen when the left atrial pressure is very high. The main pulmonary artery is prominent when it is complicated by pulmonary hypertension.

Echocardiography in the short axis view can demonstrate clefts in the anterior cusp. Doppler studies using the apical four chamber view are able to assess the severity of the regurgitation. See mitral regurgitation

LT