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LV filling pressures as measured invasively include mean pulmonary wedge pressure or mean left atrial (LA) pressure (both in the absence of mitral stenosis), LV end-diastolic pressure (LVEDP; the pressure at the onset of the QRS complex or after A-wave pressure), and pre-A LV diastolic pressure (Figure 1 ).Although these pressures are .
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In acute MR, the LV and LA might not be dilated, but LA pressure and pulmonary pressures should be significantly elevated. If all of these are normal, severe MR is very unlikely. Primary MR can be dynamic, but a severe morphological leaflet abnormality (i.e., flail leaflet) suggests severe MR.
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