Relatively Benign "Pure" Mitral Regurgitation of Rheumatic Origin

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Abstract
This study is concerned with 61 living patients above the age of 17 years with "pure" mitral regurgitation and 13 fatal cases of the same lesion in 7 of which death could be related to cardiac disease. Of the 61 living patients with "pure" mitral regurgitation, 5 gave a history of subacute bacterial endocarditis. The remaining 56 patients were cases of uncomplicated "pure" mitral regurgitation. The group of 56 cases of uncomplicated "pure" mitral regurgitation illustrate the benign character of this lesion. All of these patients have been asymptomatic, all have enjoyed fully normal, unrestricted activity, and none has shown any evidence of congestive failure or of any arrhythmia over the entire follow-up period ranging from 4 to 37 years. In the series of uncomplicated cases, 76.8% had normal ecg''s and 80% of those studied by X-ray had normal roentgenographic findings. Of particular interest was the notably low incidence of left ventricular hypertrophy by ecg (16.0%) and the absence of marked enlargement of any cardiac chamber by X-ray. It is suggested that patients with mitral regurgitation fall within a broad spectrum in regard to severity, and the group of patients satisfying criteria of this study belong in general to the mild and benign portion of this spectrum.