<prompt> Answer this question truthfullyCould you explain what ischemic mitral regurgitation means?  <response>: <reason> The clinical presentation of Ischemic mitral regurgitation reflects the state of LV dysfunction more than the state of mitral valve.Asymptomatic detected by Echocardiography or Angiography Weakness, fatigue Exercise IntoleranceApproximately one half have holosystolic murmur Decreased cardiac output Exercise produces severe regurgitation in patients with mild ischemic mitral regurgitation. Severe cases present with pulmonary edemaEffective regurgitant orifice ERO area increase with exercise is associated with increased risk for acute pulmonary edema Exercise induced ERO 13 mm2 is an independent predictor of cardiac death.3D ECHO can be helpful in differentiating ischemic mitral regurgitation from functional MR secondary to ventricular dilatation. The valvular abnormality is asymmetric in ischemic mitral regurgitation and symmetric in functional MR.ev:youtubeue2oCXo6Qik DOPPLER ECHOCARDIOGRAPHYEchocardiogram showing incomplete closure of posterior mitral leaflet due to tethering from MI 