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Mitral insufficiency (regurgitation). A: Drawing of the left heart in left lateral view showing anatomic features of mitral insufficiency. Note structures
enlarged: left atrium, left ventricle. B: Drawing showing auscultatory and hemodynamic features of mitral insufficiency. Cardinal features include systolic
backflow into left atrium, left atrial enlargement, left ventricular enlargement (hypertrophy in acute lesions), prominent v wave caused by filling from both
the pulmonary veins and the regurgitant jet, and holosystolic murmur. (3, third heart sound; SM, systolic murmur; A, aortic; P, pulmonary.) (Redrawn, with
permission, from Cheitlin MD et al, eds. Clinical Cardiology, 6th ed. Originally published by Appleton & Lange. Copyright © 1993 by The McGraw-Hill
Companies, Inc.) C: Pressure-volume loop in mitral insufficiency. Increased ventricular volumes shift the diastolic pressure-volume curve rightward. Stroke
Source: Cardiovascular Disorders: Heart Disease, Pathophysiology of Disease: An Introduction to Clinical Medicine, 7e
volume is increased because the ventricle can now eject blood into the low-pressure left atrium. With chronic volume loads, the isovolemic pressureHammer
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right. SJ. Pathophysiology of Disease: An Introduction to Clinical Medicine, 7e; 2013 Available at:
http://mhmedical.com/ Accessed: May 12, 2017
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