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Mitral regurgitation chronic — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Mitral regurgitation chronicUSMLE Step 3

A 58-year-old man with chronic primary mitral regurgitation has progressive exertional dyspnea. Echocardiography shows severe MR, flail posterior leaflet, left ventricular ejection fraction 55%, and left ventricular end-systolic dimension 43 mm. Which of the following is the most appropriate next step in management?

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Correct answer: C — Refer for mitral valve repair evaluation

Symptomatic severe primary mitral regurgitation should be referred for valve repair when feasible before irreversible ventricular dysfunction develops.

Reference: ACC/AHA Valvular Heart Disease Guideline