mitral incompetence

Last edited 11/2021 and last reviewed 11/2021

Mitral regurgitation is the retrograde flow of blood from the left ventricle into the left atrium through the mitral valve during ventricular systole.

NICE guidance with respect to asymptomatic mitral regurgitation states (1):

  • Consider referring adults with asymptomatic severe primary mitral regurgitation for intervention, if suitable, if they have any of the following:

    • LVEF less than 60%
    • ESD more than 45 mm or ESDI more than 22 mm/m2 on echocardiography or
    • an increase of systolic pulmonary artery pressure to more than 60 mmHg on exercise testing

  • when making decisions about referral for surgery, take into account the suitability of the valve for repair and the presence of atrial fibrillation or systolic pulmonary artery pressure of more than 50 mmHg on echocardiography at rest