How do primary and geometric mitral regurgitation differ?
The problem in primary mitral regurgitation is anatomically obvious. An elongated and redundant valve in mitral valve prolapsed syndrome can cause mitral regurgitation due to a sentinel collagen defect in the leaflets; infective endocarditis may destroy the valve structure by anatomical valvular or perivalvular defects; anorexigen-related valvulopathy can create defects in the valve leaflets through sclerotic mechanisms; rheumatic fever can cause thickening and fibrosis in all valve elements including the chordal structure; age-related degeneration may cause stiffening and difficulty in valve motion and sudden rupture of the subvalvular chordal elements may create a flail leaflet. Thus, one can focus on the primary aberration within the valve and attempt to restore, repair or replace the valve. Conversely, in geometric mitral regurgitation, the defect resides in the myocardial dysfunction inherent within the cardiomyopathic ventricle [2]. Geometric mitral regurgitation results from enl
