Table 18A. Stages of Primary MR
Stage Definition Valve Anatomy
A At risk of MR • Mild MV prolapse with normal
coaptation
• Mild valve thickening and leaflet
restriction
B Progressive MR • Severe MV prolapse with normal
coaptation
• Rheumatic valve changes with
leaflet restriction and loss of central
coaptation
• Prior IE
C Asymptomatic severe MR • Severe MV prolapse with loss of
coaptation or flail leaflet
• Rheumatic valve changes with
leaflet restriction and loss of central
coaptation
• Prior IE
• Thickening of leaflets with radiation
heart disease
D Symptomatic severe MR • Severe MV prolapse with loss of
coaptation or flail leaflet
• Rheumatic valve changes with
leaflet restriction and loss of central
coaptation
• Prior IE
• Thickening of leaflets with radiation
heart disease
Mitral Regurgitation
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