Which condition among the following is listed as a primary/anatomic MR etiology in the material?

Which condition among the following is listed as a primary/anatomic MR etiology in the material?

• A. MVP
• B. Bacterial endocarditis
• C. RHD
• D. Ischemia

Answer: (D)

Ischemia causes MR by directly altering the mitral valve apparatus. When myocardial ischemia or infarction affects the papillary muscles or the surrounding LV geometry, those muscles can become dysfunctional or displaced. This pulls on the chordae tendineae and tethers the mitral leaflets, so they no longer coapt properly during systole, leading to regurgitation. This structural distortion of the valve apparatus is why ischemia is listed as a primary anatomic etiology of MR. In contrast, MVP is a degenerative valvular leaflets disorder, endocarditis causes MR through infectious damage, and rheumatic disease produces leaflet deformity from inflammation—each via a different mechanism rather than ischemia-induced distortion of the subvalvular apparatus.

Ischemia causes MR by directly altering the mitral valve apparatus. When myocardial ischemia or infarction affects the papillary muscles or the surrounding LV geometry, those muscles can become dysfunctional or displaced. This pulls on the chordae tendineae and tethers the mitral leaflets, so they no longer coapt properly during systole, leading to regurgitation. This structural distortion of the valve apparatus is why ischemia is listed as a primary anatomic etiology of MR. In contrast, MVP is a degenerative valvular leaflets disorder, endocarditis causes MR through infectious damage, and rheumatic disease produces leaflet deformity from inflammation—each via a different mechanism rather than ischemia-induced distortion of the subvalvular apparatus.