Mitral Regurgitation Differential Diagnoses

Updated: Dec 08, 2021
  • Author: Ivan Hanson, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Diagnostic Considerations

It is essential that clinicians identify mitral regurgitation (MR), define its cause (including whether the MR is primary or secondary) and the Carpentier classification of leaflet motion, assessing the MR severity, make treatment decisions with the heart valve team, and follow-up with clinical cardiology and the primary care provider. [11, 12]

Calcified aortic stenosis also produces a prominent murmur at the apex (Gallavardin phenomenon) and may be confused with mitral valve regurgitation.

Tricuspid regurgitation also causes a holosystolic murmur. However, it is located at the left lower sternal border rather than the apex, it does not radiate to the axilla, and it increases in intensity with inspiration, whereas MR does not.

A ventricular septal defect produces a harsh holosystolic murmur at the lower left sternal border, but it generally radiates to the right of the sternum rather than the axilla and typically has a thrill.

Differential Diagnoses