Grading severity of mitral regurgitation by echocardiography

	Mild (1+)	Moderate (2+)	Severe (3 to 4+)
Jet size (percent left atrium)	<20%	20 to 40%	>40% for a central jet or variable size for an eccentric wall-impinging jet
Jet duration	Often brief (ie, mid-late systolic jet)	Variable (includes late systolic eccentric jet)	Holosystolic jet
Vena contracta (mm)	<3	3 to 6.9	≥7

TEE variables used to assess mitral regurgitation. The above criteria apply to chronic mitral regurgitation (MR). In acute MR, the MR jet velocity may be lower, the jet area may not be large, and the jet is often markedly eccentric; thus acute MR may be underestimated or not appreciated. Presence of the combination of a flail leaflet or ruptured papillary muscle, pulmonary vein flow reversal, and a hyperdynamic left ventricle with low systemic output by Doppler suggest acute MR.

MR: mitral regurgitation.

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Grading severity of mitral regurgitation by echocardiography