Copyright © 1991 by the European Society of Cardiology.
© 1991 The European Society of Cardiology
Significance of a mitral regurgitation systolic murmur complicating a first acute myocardial infarction in the coronary care unit — assessment by colour Doppler flow imaging
Faculty of Medicine, Kuwait University Kuwait
Received 2 February 1990; revised 25 July 1990; .
Correspondence: Dr S. K. Bhatnagar, II Mailing House, Park Road, Beckenham BR3 1PZ
Abstract
To determine the prevalence and significance of a systolic mitral murmur heard after a first acute myocardial infarction (MI), we studied 186 consecutive patients in the coronary care unit (CCU) during a one-year period. Fifteen patients had a murmur as a result of mitral regurgitation (MR) (prevalence 8%) documented by colour Doppler flow imaging. It was heard before the third day of hospitalization in 10 (67%) patients, and on the third day itself in the remainder. The severity of MR was graded semi-quantitatively: moderate in 12 (80%) patients, and mild, moderate to severe and severe in three respectivety. The direction of the MR jet, determined by colour flow imaging, improved the information obtained by two-dimensional echocardiography (2D echo) that could only diagnose mitral leaflet abnormality in seven (47%) patients. in 10 of 15 (67%) patients, the 2D echo ejection fraction was 
40% and in eight (53%) the wall motion score obtained by analysing 11 left ventricular (LV) segments was $$$8. Two (13%) patients died in tile CCU, four (27%) had LV failure, one angina and eight (53%) remained asymptomaric in the hospital. Of 171 patients without a systolic murmur, 22 (13%) had LV failure, 13 (8%) angina and 25 (15%) died during the in-hospital stay (P-NS for these complications between patients with and without MR murmur). During a follow-up of 12–24 months, one MR patient died, and seven (47%) remained asymptomatic.
We conclude that the prevalence of MR systolic murmurs in acute MI patients is low. The LV function and the prognosis of a majority of these patients is rather good.
Key Words: Mitral regurgitation • acute myocardial infarction
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E. Agricola, M. Oppizzi, M. Pisani, A. Meris, F. Maisano, and A. Margonato Ischemic mitral regurgitation: mechanisms and echocardiographic classification Eur J Echocardiogr, March 1, 2008; 9(2): 207 - 221. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. R. Mallidi, M. P. Pelletier, J. Lamb, N. Desai, J. Sever, G. T. Christakis, G. Cohen, B. S. Goldman, and S. E. Fremes Late outcomes in patients with uncorrected mild to moderate mitral regurgitation at the time of isolated coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 636 - 644. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. He, A. A. Fontaine, E. Schwammenthal, A. P. Yoganathan, and R. A. Levine Integrated Mechanism for Functional Mitral Regurgitation : Leaflet Restriction Versus Coapting Force: In Vitro Studies Circulation, September 16, 1997; 96(6): 1826 - 1834. [Abstract] [Full Text]
|
|