What initial tests should be ordered for suspected mitral regurgitation?

The initial tests for suspected mitral regurgitation primarily focus on evaluating the heart's structure and function, with an emphasis on the mitral valve. Transthoracic echocardiography (TTE) is the preferred initial imaging study because it is non-invasive and provides valuable information on the anatomy and function of the heart, especially the mitral valve. It allows assessment of the degree of regurgitation, chamber sizes, and the overall cardiac function.

An electrocardiogram (ECG) is also a crucial initial test as it can reveal any underlying arrhythmias or left atrial enlargement, which are commonly associated with mitral regurgitation due to volume overload.

While transesophageal echocardiography (TEE) provides more detailed images and could be used later if there are questions concerning the valve structure that TTE cannot answer, it is not typically used as an initial test because it is more invasive. CT scans and ultrasounds do not provide the specific cardiac functional and structural information needed for this condition, making them less suitable initial choices.