Diastolic Mitral Regurgitation With Interatrial Left-to-Right Shunt.

BACKGROUND

Diastolic mitral regurgitation (MR) occurs when left ventricular pressure exceeds left atrial pressure during diastole, resulting from a reverse atrioventricular gradient. Diastolic MR is occasionally detected in patients with structural mitral valve abnormalities, left ventricular dysfunction, atrioventricular block, or severe aortic regurgitation. However, there are no reports on diastolic MR associated with interatrial left-to-right shunts.

CASE SUMMARY: Case 1 was a 66-year-old man diagnosed with an atrial septal defect and diastolic MR between the E wave and A wave. Case 2 was a 37-year-old woman with an incomplete atrioventricular septal defect and diastolic MR between the E wave and A wave. Case 3 was a 78-year-old man with iatrogenic atrial septal defect after pulmonary vein isolation and diastolic MR.

CONCLUSIONS

Diastolic MR may suggest the presence of an interatrial shunt, along with other factors affecting left ventricular function.