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. 2020 Oct 13;115(4):720–775. [Article in Portuguese] doi: 10.36660/abc.20201047

Table 10. Step 2: Evaluation of severe primary mitral regurgitation etiology33–35.

Etiological characteristics
Rheumatic

  • Most prevalent cause in Brazil

  • Thickening with cusp retraction

  • Commissural involvement

  • Mitral-aortic involvement

  • Frequent in young adults
Mitral valve prolapse and associated diseases (Barlow syndrome)

  • Second most frequent cause in Brazil

  • Cusp protrusion into the LA ≥ 2 mm

  • More frequent in middle-aged and elderly populations
Other causes

  • Infective endocarditis

  • Marfan syndrome

  • Systemic lupus erythematosus

  • Traumatic lesions

  • Congenital deformities

LA: left atrium.