Changes

====Echocardiography====

====Echocardiography====

Evidence of left atrial and left ventricular enlargement is visible on echocardiography. The 'fractional shortening' on M wave echography is also increased which is measured as the percentage change in the left ventricular diameter during systole and is used as a measure of systolic function. It is also possible to see structural changes in the valve leaflets in some cases. It may detail irregularities of the valves affected (e.g. thickening, shortening, and/or prolapse of the valve leaflets), abnormal valve movements &  valve regurgitation, left atrial enlargement (wide P wave) and left ventricular dilation (tall R wave, wide QRS complex). The regurgitant jet of blood can be detected using colour doppler and evidence of turbulent flow.  

* Prolapse of mitral valve leaflets into the left atrium during systole

* Tricuspid leaflets may also be affected, though usually not as severely as the mitral valve

* Doppler evidence of turbulent flow within the left atrium during systole

* Fractional shortening may be increased. This is because in the setting of mitral regurgitation impedance to ventricular emptying is reduced (blood can be ejected into the low pressure left atrium)and end-diastolic ventricular stretch is increased by the addition of the regurgitant fraction, increasing the force of contraction. A reduced fractional shortening in the presence of DMVD indicates systolic dysfunction.

===Electrocardiogram (ECG)===

===Electrocardiogram (ECG)===