Chronic Mitral Regurgitation :  In chronic mitral regurgitation, the asymptomatic phase is much longer than in mitral stenosis. Onset of symptoms may also mean the onset of left ventricular dysfunction. Asymptomatic patient with mild MR with no evidence of left ventricular. Enlargement or dysfunction or pulmonary hypertension can be medically followed up. In patients with moderate MR annual check up with echocardiography should be done. Asymptomatic patients with severe MR should have assessment every six months. Exercise stress testing may be needed in some cases.