Which diagnostic tests are recommended for confirming mitral regurgitation in primary care?

In primary care, the recommended diagnostic test to confirm mitral regurgitation is an echocardiogram, which should be considered for adults presenting with a murmur suggestive of valve disease, especially if accompanied by relevant clinical features such as symptoms (e.g., breathlessness, angina), signs (e.g., peripheral oedema), abnormal ECG, or risk factors including family history and age over 75 years ¹.

An echocardiogram provides definitive imaging to assess the presence and severity of mitral regurgitation and is the key investigation to confirm diagnosis and guide further management ¹.

Exercise testing may be considered as an adjunct in selected cases to evaluate functional capacity and symptom correlation in mitral regurgitation, but it is not a primary diagnostic tool in primary care ¹ (Dulgheru et al., 2017).

Urgent echocardiography and specialist referral are indicated if there are severe symptoms or concerning signs such as exertional syncope alongside a murmur ¹.