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November 2, 1984

Aortic and Mitral Regurgitation: How to Evaluate the Condition and When to Consider Surgical Intervention

JAMA. 1984;252(17):2447-2449. doi:10.1001/jama.1984.03350170049018

AORTIC and mitral regurgitation represent two relatively common causes of left ventricular volume overload. Although diseases that produce aortic or mitral regurgitation may also produce narrowing of the valve orifice, resulting in some degree of stenosis, pure aortic and/or mitral regurgitation (without associated valve stenosis) occur commonly, and this review focuses on the natural history and treatment of patients with pure aortic and/or mitral regurgitation. In both aortic and mitral regurgitation, the left ventricle must accommodate an increased amount of blood in diastole: in aortic regurgitation, this extra diastolic blood is the direct consequence of the aortic valvular leak, whereas in mitral regurgitation, the extra diastolic load is the indirect result of the fact that blood regurgitated from the left ventricle into the left atrium during systole must ultimately return to the left ventricle during subsequent diastoles. The diastolic volume overload of aortic and mitral regurgitation initially increases diastolic wall