When should a patient with mitral regurgitation get a cardiac MRI?
The initial evaluation should be with echocardiography. If the echocardiogram clearly shows the regurgitation is mild, no MRI is warranted. However, if the echocardiogram is not definitive, most patients benefit from (and would prefer) a noninvasive MRI instead of an invasive transesophageal echo. Furthermore, if echocardiography suggests the degree of regurgitation is moderate or severe, MRI is helpful to quantify the leak, quantify left ventricular size and function, and serve as a baseline for subsequent follow-up studies. Finally, if surgery is being considered in a patient with “severe” mitral regurgitation based on echocardiography, a cardiac MRI should be strongly considered to avoid or delay a potentially unnecessary surgery. If the patient has had multiple echocardiographic studies that show severe mitral regurgitation, should cardiac MRI still be considered? Definitely, yes. Multiple studies performed the same way and using the same criteria only prove reproducibility, not ac
