Bilateral Diastolic Atrio-ventricular Valvular Regurgitation in Mobitz type II atrioventricular block: case report

Diastolic mitral regurgitation (DMR) is commonly observed during atrioventricular (AV) block, severe aortic regurgitation, restrictive cardiomyopathy, and dilated cardiomyopathy with severe left ventricular dysfunction. It is outcome of atrial contraction which is not followed by adequately synchronized ventricular contraction which results into reversal of AV pressure gradient during atrial diastole. Here, we report a case of diastolic mitral regurgitation (DMR), pulmonary hypertension, and diastolic tricuspid regurgitation (DTR) in a 57-year old patient who presented with dyspnoea and syncope with 2:1 atrioventricular block. Careful analysis of echocardiogram with online electrocardiogram is an important tool to delineate the timing of DMR.