Patients with heart failure are classified in four categories
depending on their symptoms with exertion. (1) In non-
symptomatic patients with chronic mitral regurgitation, their
cardiac output is not compromised. They do not need any specific
treatment, although they are closely monitored with regular
echocardiograms. (2) In symptomatic patients with chronic mitral
regurgitation, medications are directed to relieve the symptoms.
Some of the medications increase the cardiac output & heart’s
contracting ability, reduce blood pressure or remove excess
water and sodium from the body. (3) In acute mitral
regurgitation, the patient should be evaluated for heart attack
first and treated promptly. Diuretics should be started in case
of pulmonary congestion. Blood pressure must be kept normal and
atrial fibrillation must be controlled. (4) Surgery is indicated
in acute MR patients in congestive heart failure or shock.
Chronic MR patients with class III or IV symptoms require
surgery. Intervention is also recommended f