The severity of mitral regurgitation (MR) can be graded based on changes seen on left ventricular angiography.
Method: A catheter is passed along the aorta into the left ventricle and contrast material is released.
Findings on Angiography
no contrast material enters left atrium
a small amount of dye enters left atrium during systole but (a) does not fill the atrium and (b) is cleared progressively with each cardiac contraction
more contrast material enters the left atrium with a few beats, with faint opacification of the left atrium
left atrium becomes well-opacified with a few beats, resulting in a density matching that in the left ventricle
left atrium completely opacified on first systolic contraction
• If there the ejection fraction was 100% then all of the contrast material would be ejected in the first systolic contraction. With severe mitral regurgitation there is a reduced ejection fraction, which means more dye is left to regurgitate into the left atrium.
• In theory the grades could be subdivided (2.5, 3.5) but I am not sure if there is any benefit to this.
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