A 60-year-old man on ICU has severe mitral regurgitation with pulmonary oedema. He is on CPAP and IV GTN infusion. His BP is 150/85. The team notes th...

Question

A 60-year-old man on ICU has severe mitral regurgitation with pulmonary oedema. He is on CPAP and IV GTN infusion. His BP is 150/85. The team notes that GTN reduces his pulmonary oedema. What is the mechanism by which GTN improves acute mitral regurgitation?

Accepted Answer

GTN causes venodilation (reducing preload/LV volume) and arteriolar vasodilation (reducing afterload/SVR); the reduction in afterload decreases the regurgitant fraction by reducing the pressure gradient across the incompetent mitral valve, promoting forward flow into the aorta rather than backward into the left atrium

Answer

GTN directly repairs the mitral valve

Answer

GTN is a positive inotrope

Answer

GTN causes pulmonary vasoconstriction

Answer

GTN has no haemodynamic effect on MR

uk-fficm MCQ (SBA): Acute Mitral Regurgitation

A 60-year-old man on ICU has severe mitral regurgitation with pulmonary oedema. He is on CPAP and IV GTN infusion. His BP is 150/85. The team notes that GTN reduces his pulmonary oedema. What is the mechanism by which GTN improves acute mitral regurgitation?