In elderly patients, what is the most common cause of mitral regurgitation?

In elderly patients, what is the most common cause of mitral regurgitation?

• A. HOCM
• B. MAC
• C. Rheumatic fever
• D. Bicuspid aortic valve

Answer: (B)

Degenerative calcification of the mitral annulus is the most common reason for mitral regurgitation in older adults. As people age, the fibrous ring that supports the mitral valve often accumulates calcium, making the annulus stiff and less able to allow the leaflets to coapt properly during systole. This imperfect closure lets blood flow backward into the left atrium, producing chronic MR. Echo typically shows calcification around the mitral annulus with restricted leaflet motion and a regurgitant jet. Other conditions like hypertrophic cardiomyopathy can cause MR but are not as prevalent in the elderly; rheumatic disease has become less common in this age group; a bicuspid aortic valve is primarily an aortic valve issue, not the leading cause of MR in older patients.

Degenerative calcification of the mitral annulus is the most common reason for mitral regurgitation in older adults. As people age, the fibrous ring that supports the mitral valve often accumulates calcium, making the annulus stiff and less able to allow the leaflets to coapt properly during systole. This imperfect closure lets blood flow backward into the left atrium, producing chronic MR. Echo typically shows calcification around the mitral annulus with restricted leaflet motion and a regurgitant jet.

Other conditions like hypertrophic cardiomyopathy can cause MR but are not as prevalent in the elderly; rheumatic disease has become less common in this age group; a bicuspid aortic valve is primarily an aortic valve issue, not the leading cause of MR in older patients.