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The diagnosis of a moderate grade of mitral regurgitation in this patient has to be related with all the other clinical findings (severely reduced EF%; increased LV filling pressures; patient history; a thorough investigation of the patient’s symptoms). In the setting of secondary mitral valve regurgitation, the indications for intervention are different than in the case of primary regurgitation. The result of an algorithm based on current Guidelines shows no indication for intervention:

Given the finding of increased LV filling pressures, the patient is in need of an increase in preload-reduction therapy, and echocardiographic follow-up to monitor the efficacy of medical therapy.