How should I manage a patient with asymptomatic mitral regurgitation and preserved left ventricular function?

Management of a patient with asymptomatic mitral regurgitation and preserved left ventricular function involves regular monitoring and specialist referral rather than immediate intervention.

Specifically, adults with moderate or severe mitral regurgitation should be referred to a specialist for assessment and ongoing management, even if asymptomatic and with preserved left ventricular function.

Intervention, such as surgical mitral valve repair or replacement, is generally reserved for patients with severe primary mitral regurgitation who are symptomatic or have evidence of left ventricular dysfunction or other indications for surgery.

In asymptomatic patients with preserved left ventricular function, conservative management with regular echocardiographic surveillance is recommended to monitor for progression of valve disease or onset of symptoms.