Anemia producing mitral valve flutter on the echocardiogram.

Thirty-four patients in sinus rhythm with anemia due to chronic renal failure and one subject with chronic uterine bleeding were studied by means of echocardiography. Six patients (18%) had major diastolic fluttering of the mitral valve, and in 4 others the fluttering was equivocal. No subject had auscultatory or other clinical evidence of aortic insufficiency. In the patient with uterine hemorrhage, diastolic mitral valve motion reverted to normal after blood transfusion. It is concluded that anemia may produce diastolic mitral valve fluttering, which is probably based on increased blood flow in this setting. Caution should be exercised in ascribing diastolic murmurs associated with uremia to aortic regurgitation when anemia is present.